Private In Brazil Research Articles

Price setting in the Brazilian private health insurance sector.

Brazil's private health insurance market is the second largest in the world, behind only the United States, making it a valuable source of real-world evidence. This paper documents how physicians' inpatient reimbursement fees vary in the country and explores the relationship between these fees and the market share of health providers and health insurance companies. We implement a fixed-effects panel regression and take advantage of an unprecedented database that contains national administrative records of inpatient procedures paid by health insurance companies in 2016. We find a positive correlation between reimbursement for ICU procedures and provider market share. Conversely, we observe a negative correlation with insurers' market share. Additionally, we document substantial variation in procedure prices, both across and within Brazilian states, and observe that more competitive markets in Brazil tend to have higher population and GDP levels. Overall, our research enhances our understanding of the price setting dynamics of physician reimbursement fees in the context of a developing country. The insights gained from this study can assist policymakers in formulating appropriate regulations to ensure appropriate access to healthcare services.

EE495 Cost-Effectiveness of Pembrolizumab + Axitinib Versus Nivolumab + Ipilimumab As First-Line Treatment of Advanced Renal Cell Carcinoma in the Private Healthcare System in Brazil

In Brazil's Private Healthcare System, intravenous (IV) oncological drugs approved by the regulatory agency are automatically reimbursed. However, when the treatment involves an oral drug, it must go through the health technology assessment (HTA) process for reimbursement approval. In this context, we conducted a study to evaluate the cost-effectiveness of pembrolizumab (IV) + axitinib (oral) versus nivolumab (IV) + ipilimumab (IV) as first-line treatments in patients with advanced renal cell carcinoma (aRCC) at intermediate/poor IMDC (International Metastatic RCC Database Consortium) risk.

Does The Privatization Worth It? Factors Influencing the Quality of the Brazilian Privatization

The state's economic participation has been intensely debated over the past three decades. In Brazil, especially after the advent of the Federal Constitution of 1988. Privatization in Brazil, however, was instituted by Law 8.130/90, which instituted the National Privatization Plan, aiming to transfer to the private sector activities improperly exploited by the public sector. This article investigates the quality of services provided by privatized companies or public concessions through interviews. The main conclusions indicated a complex privatization process, as there is evidence related to five topics: (i) oversight, (ii) quality in privatization, (iii) regulation, (iv) competition, and (v) public service. In addition, the careful analysis suggested implications for the privatization process and public concessions. In addition, implications for the public administration to focus its efforts on improving oversight and scheduling itself in pre-regulating the privatization process. Finally, free competition aimed at competitiveness and low prices are topics to be discussed in this article.

Real world data study of prevalence and direct costs related to dengue management in Brazil's private healthcare from 2015 to 2020.

The burden of dengue in Brazil is poorly documented and is based on data from the public health care setting. This study estimated the prevalence and costs of dengue management in the private health care system in Brazil from 2015 to 2020 using a large claims database from Orizon. We selected claims with dengue ICD codes (ICD-10 A90 or A91) from January 2015 to December 2020. Prevalence was estimated based on the population enrolled in health insurance plans in the given year. Costs were adjusted for the inflation up to December 2021 and evaluated by measures of central tendency and dispersion. A total of 63,882 unique beneficiaries were included, with a total of 64,186 dengue cases. The year with the highest prevalence was 2015 (1.6% of patients who used health plans), and there was also an increase in cases in 2016 and 2019. The median cost per hospitalization in 2015 was US$486.17, and in 2020, it reached US$696.72. The median cost of a case seen at an emergency room ranged from US$ 97.78 in 2015 to US$ 118.16 in 2017. The estimated prevalence of dengue in this population of private health-insured patients followed the epidemiological trends of the general population in Brazil, with the highest rates in 2015, 2016, and 2019. The cost of dengue management has increased in the private health care setting over the years.

The Evolution of Privatization in Brazil: The Case of Embraer

State participation in the economy has been intensely debated over the past three decades. In Brazil, especially after the advent of the Federal Constitution in 1988. Privatization in Brazil, however, was instituted by Law 8.130/90, which established the National Plan for Privatization, aiming at transferring to the private sector activities unduly exploited by the public sector. In this article, we investigated one of the most significant privatizations in Brazilian history, the case of Embraer, the world's third largest civil aircraft manufacturer. Key findings pointed out a complex privatization process, including golden share vetoes and institutional challenges faced by Embraer, such as the first Brazilian company to adopt the International Financial Reporting Standards (IFRS) fully. In addition, the careful analysis suggested implications for the reduction of public debt. Also, the resumption of investments in companies and activities transferred to the private sector, modernization of the country's industrial park, increasing its competitiveness, and reinforcing business capacity in Embraer's jet C-series sector and military aircraft, for instance. Also, implications for the public administration to focus its efforts on actions where the State's presence is necessary for achieving national priorities. Finally, the strengthening of the capital market, as well as the democratization of the ownership of the capital of Embraer are topics to be debated in the present article.

Dropout: Demographic Profile of Brazilian University Students

This study analyses dropout in higher education, a worldwide problem seen in the literature of developed and developing countries. The aim of the study is to explain dropout in Brazil's private higher education. Dropout is defined as the interruption of studies by students in higher education enrolled for any length of time, regardless of university change before its conclusion. This research uses data from students, which are the main population in higher education. Thus, the research is based on a survey questionnaire conducted to a higher education student population. These students can be divided in two categories to be compared: the regular private higher education students and the college students who have stopped their studies. The empirical study begins by a characterization of the respondents, followed by a logistical regression in order to identify the determinants of dropout. Age, change of marital status during the course, having scholarship and asking for funding were considered as determinants of dropout. Results of this research give contribution to young students, the society, the government, private higher education institutions and indirectly to the companies.

Distribution of dental schools in Brazil, 2015

Abstract Introduction: The geographical distribution of dentistry schools has been the object of study in Brazil and in other parts of the world. Aim: To analyze the distribution of dentistry schools in Brazil by states and to correlate with the number of dentists in 2015. Methods: This is a cross-sectional study. The analysis of the courses distribution was carried out by states and categorized by public or private schools. All the institutions′ addresses were geocoded and mapped to illustrate the spatial distribution of dental courses. To determine the association between the number of faculties by state and the number of dentists, the Spearman correlation test was applied with the level of decision (alpha = 0.05) for correlating the variables. Results: The distribution of schools and dentists were irregular. In 2015, there were 232 dental courses in operation; being 56 (24%) public and 176 (76%) private in Brazil, and all 26 states and the Federal District have dental courses. The Spearman test showed a strong positive correlation between the number of dental schools and the number of dentists. Conclusion: The distribution of dental schools has reflexes in the distribution of health professionals.

Logística reversa como meio de instrumentalização organizacional do desenvolvimento sustentável

Logística reversa como meio de instrumentalização organizacional do desenvolvimento sustentável

Ecotourism as a conservation tool and its adoption by private protected areas in Brazil

Ecotourism in private reserves combines the establishment of protected areas with an incentive mechanism to conserve biodiversity. Brazil's private reserve system is well-established but little is known about its links to tourism. This study puts the global private protected area into context and quantifies the extent to which ecotourism has been adopted as a sustainable land-use practice on private reserves in Brazil. Our findings demonstrate that small reserves do contribute to conservation and are used for ecotourism. The belief that large reserves are necessary for ecotourism and conservation is challenged. Only 4% (n = 45) of the 1182 reserves are engaged in ecotourism, mainly those within the Atlantic Forest biome and these are generally small in size (<50 ha). Reserves provide modest to basic accommodation as well as education and economic opportunities that include adjacent communities. Hiking and bird watching are the most popular activities but many reserves are threatened by poaching and invasive species. The low adoption of ecotourism appears due to a combination of factors, including lack of landowner interest, constraints imposed by regulations, logistics and anthropogenic threats. Nonetheless, there is potential to expand ecotourism within private reserves as 143 further private reserves are located near those already engaged in ecotourism.

Shrimp aquaculture in the federal state of Ceará, 1970–2012: Trends after mangrove forest privatization in Brazil

During the last 40 years, industrial shrimp farming in Brazil has experienced intense development. The first shrimp culture experiments were carried out at the beginning of the 1970s, but due to technical problems and a lack of exact knowledge they were not very successful. At the end of the 1990s, the activity expanded rapidly and shrimp farming became a relevant export industry, due to government assistance, public-bank financing, university technical collaboration and legislative permissiveness. The vertiginous growth of the industry has been accompanied by a profound transformation of natural resources, causing the degradation of the mangrove ecosystem. The objective of this study is to conduct an integral and in-depth analysis of the evolution of the industrial shrimp farming in Brazil, based on a review of the national political and economic context of the aquaculture activity, and also an evaluation of the environmental impacts of shrimp farming in the watershed of the Jaguaribe River, Ceará (NE Brazil). This analysis begins with the initiation of intensive large-scale farming for export, taking into account the synthesis of environmental processes to analyse the socio-environmental impacts.We studied the areas used for the construction of shrimp farms, located in coastal and estuarine systems and with tidal connections, linking the transformation of the system with the, geo-environmental evolution of the impacted zones, mainly the mangrove ecosystem. The final objective of this work is to propose an integral model of management for the appropriate use of mangroves in Brazil and other systems with analogous problems.

Employee spinoffs and other entrants: Stylized facts from Brazil

We gauge the prevalence and performance of firms founded as employee spinoffs, relative to other new firms with and without parents, and relative to diversification ventures of existing firms entering new industries. Using a comprehensive linked employer–employee database from Brazil for the universe of formal firms during the period 1995–2001, we are able to identify an employee spinoff either when the director/manager moved from a parent in the same industry or when one-quarter of the employees shifted from a common parent. Depending on definition, employee spinoffs account for between one-sixth and one-third of the new firms in Brazil's private sector during this period. Regardless of definition, size at entry is larger for employee spinoffs than for new firms without parents but smaller than for diversification ventures of existing firms. Similarly, survival rates for employee spinoffs are higher than for new firms without parents and comparable to those for diversification ventures of existing firms. These results suggest that we can think of some part of a firm's productivity and riskiness as embodied in the firm's employees and portable.

The Ownership Structure of Corporations: Political Connections from the Resource Dependence Perspective – A Theorical Essay

After the 90s, which heralded the era of privatization in Brazil, the government became a shareholder in various private companies. Government participation can interfere in the objectives, strategies and ultimately in the performance and survival of corporations. This paper aims to discuss this phenomenon and the importance of political connections in terms of ownership structure for an organization's survival. The objectives of governments as owners tend to conflict with those of other shareholders, because their goals tend to have more of a social and political element, which can lead to organizational deficiency in the performance of the company. One may come to believe that when a company has the government as a shareholder, its survival is ensured, as suggested by the theory of resource dependence, but this participation may in fact negatively affect the company's performance due to government objectives. This work proposes a way to mitigate the problem while ensuring the benefits of this connection with the government by reducing the stake of government in companies to minimum levels, which would reduce the risk of political interference.

A ESTRUTURA DE PROPRIEDADE DAS CORPORAÇÕES: CONEXÕES POLÍTICAS SOB A PERSPECTIVA DA DEPENDÊNCIA DE RECURSOS

After the 90s, which heralded the era of privatization in Brazil, the government became a shareholder in various private companies. Government participation can interfere in the objectives, strategies and ultimately in the performance and survival of corporations. This paper aims to discuss this phenomenon and the importance of political connections in terms of ownership structure for an organization's survival. The objectives of governments as owners tend to conflict with those of other shareholders, because their goals tend to have more of a social and political element, which can lead to organizational deficiency in the performance of the company. One may come to believe that when a company has the government as a shareholder, its survival is ensured, as suggested by the theory of resource dependence, but this participation may in fact negatively affect the company's performance due to government objectives. This work proposes a way to mitigate the problem while ensuring the benefits of this connection with the government by reducing the stake of government in companies to minimum levels, which would reduce the risk of political interference.

Costs and Benefits of Privatization: Evidence from Brazil

Although the Brazilian privatization program has been a sweeping endeavor involving more than 100 firms and billions of dollars, most of the studies have been published only in Brazil, and in Portuguese. This paper is the most comprehensive study to date in terms of the companies covered, and includes the most recent data. It looks at the results of privatization in Brazil for a broad range of economic variables to answer the question: Has the widespread popular discontent with the program been justified? The paper also examines the effects of privatization on aspects that affect the development of financial markets, including minority shareholder rights. It concludes with recommendations for democratizing capital ownership through public offers in which workers would be entitled to participate using public sector liabilities such as FGTS deposits.

Os desafios da ANS frente à concentração dos planos de saúde

The effects of the financial consolidation of Brazil's private health plan market warrants investigation, as this trend could enhance the power of large plans and affect the financing of the National Health System. From the standpoint of the political economics of this sector, while reflecting on the features of this consolidation, this paper discusses whether this more powerful market clout might require the State to adopt a more active stance, especially if it wishes to enforce the normative principles of the National Supplementary Health Regulator in order to protect consumers, ensure regulated competition and defend the public interest.

Retail prices of essential drugs in Brazil: an international comparison

Price is a key obstacle for consumer access to essential drugs, especially in developing countries. This study sought to compare the retail prices of essential drugs on the private market in Brazil with that of two international pricing standards. The retail price of all drugs on Brazil's Essential Drugs List, July 2000 edition, were compared to the retail price of the same drugs on the Swedish market and on a referential bulk-price indicator from low-cost suppliers on the international market. Ratios of Brazil's prices to Sweden's prices and Brazil's prices to the international bulk mean price-per-unit for each drug were calculated. Using linear regression analysis, the ratios were also studied in relation to the number of manufacturers. For the 132 drugs that were listed on both Brazil's and Sweden's lists, unitary retail prices in Brazil were 1.9 times higher. Of the 94 drugs found on both Brazil's list and the international unit-price indicator, Brazil's national mean unit prices were 13.1 more expensive. No relationship was found between the number of manufacturers for each product and the ratios of prices. Average retail prices of essential drugs in Brazil are significantly higher than in Sweden. Furthermore, international bulk prices indicate that drugs are brought to market by Brazil's private pharmacies at prices that may be excessively high in relation to production costs, creating high profit margins. The expected price-lowering effects of competition were not identified.

A sistematização da previdência privada brasileira e uma abordagem de aspectos previdenciários no exterior

The present essay is about a brief systemisation of Brazil's private retirement plans, drafting an approach of social security in Italy, Chile and USA.

Fundos de pensão, mercados de capitais e Corporate Governance: lições para os mercados ermegentes

Nos seus vinte anos de existência, o sistema brasileiro de previdência complementar acumulou ativos de mais de 70 bilhões de reais. Existe um crescente debate sobre o papel que os fundos de pensão podem desempenhar na economia brasileira. Alimenta-se uma esperança de que eles possam contribuir em três áreas fundamentais: (a) financiamento do desenvolvimento, (b) expansão dos mercados de capitais e (c) democratização do capital (desconcentração da estrutura de propriedade corporativa). Este trabalho procura extrair da experiência dos países industrializados algumas perspectivas que possam contribuir para o debate em torno do crescimento e atuação de fundos de pensão nos mercados emergentes.

Land, property rights and privatization in Brazil

The settlement of the Amazon has attracted considerable attention due to its environmental and economic consequences. It is, however, not an entirely new phenomena, but the last stage of a long process of frontier settlement which started in other regions almost 500 years ago. The section on privatization of land describes the historical process through which land was occupied in Brazil and identifies a pattern which has been repeated in each new frontier region involving the interrelationships between land prices, property rights and agricultural investment. This pattern has recurred in the Amazon frontier, whose settlement ever since the sixties has been directly influenced by governmental policy. Land policy in the Amazon examines governmental policy and some of its consequences with emphasis on the supply of property rights in land. As has been the case throughout Brazilian history, land policy in the Amazon has rarely achieved its objectives. This has occurred not only because of the difficulties in enforcing and monitoring policy, but also to a lack of understanding of the role of property rights and other forces which shape incentives for the use and disposal of land. Property Rights in the Amazon shows how the lack of secure property rights in land has been connected to many of the problems which have arisen throughout the settlement of the Amazon.