O Risco Moral No Sistema De Saúde Suplementar Brasileiro

The aim of this paper is to investigate the existence of moral hazard in the Brazilian health system. The dataset used is the 1998 PNAD (Pesquisa Nacional por Amostra Domiciliar), a Brazilian household sample survey. Brazilian health system is characterized as a mixed system: the public sector guarantees a full and free access for all individuals, whereas the private insurance is allowed to dispose supplemental health coverage. Nowadays, 25% of the whole population has private insurance. This analysis relies on a household heads sample, since they are responsible to the family decision to purchase supplemental plan. Two variables of healthcare utilization have been selected: medical visits and the number of inpatient days. These variables represent different types of healthcare and processes of making decisions. We estimate the over utilization in the private sector using a counter-factual analysis. The main findings suggest a moral hazard for both types of healthcare: for the visits model, we found that each individual in the private sector uses 32% more services than if they only have access to public services. For inpatient days, we found that each individual in the private sector uses 56% more services than if they only have access to public services.