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Rev Assoc Med Bras (1992). 2013 Nov-Dec;59(6):600-6. doi: 10.1016/j.ramb.2013.06.017. Epub 2013 Nov 9.

Supplemental care from a bioethical perspective.

[Article in English, Portuguese]

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Programa de Pós-Graduação em Bioética, Universidade de Brasília, Brasília, DF, Brasil. Electronic address:



To describe and analyze, from the perspective of Intervention Bioethics, the legal, institutional and ethical contexts, the conflicts and regulations of supplemental health care in Brazil, since the approval of the regulatory law in 1998 until 2010.


Qualitative research, using Intervention Bioethics as the theoretical reference. Bibliographical and documental study of the legislation, regulations and assistential framework, as well as interviews with members of the Supplemental Health Board.


There was improvement in the records and rules of action in private health companies, as well as flow of information, contractual and financial guarantees provided to consumers. Conflicts persist regarding access to services and procedures, price increases, policies on autonomy and medical fees. There is a dispute with the public sector regarding the network of health services, with rising costs and no improvement in quality of care.


Private participation in health demands comparative assessments and improvement of public-private care regulation, as well as promoting greater balance in the funding and reevaluation of the health care model.


It is necessary to review the regulatory framework considering the supplementary, complementary or duplicate characteristic of assistance, the social actors involved, bioethical and political issues regarding associations between Supplemental Health Care and the National Health System (SUS).


Bioethics; Bioética; Participação público-privada; Public-private partnerships; Saúde suplementar; Supplemental health; Universalization of health; Universalização da saúde

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