Unequal participation of consumers and private health plans in the Brazilian Regulatory Agency for Private Health Insurance and Plans

Social participation is an essential element for the democratic legitimization of regulatory decisions, as well as an important instrument of accountability in regulatory agencies. This article presents the results of a quantitative research carried out with the instruments of social participation of the Brazilian Regulatory Agency for Private Health Insurance and Plans, specifically the Private Health Insurance and Plans Advisory Committee, its commissions and committees, public hearings, public consultations, technical councils, and technical groups. The study sought to measure the participation of Brazilian health insurance market stakeholders within the agency. These were divided in five categories??????private health insurance companies,??? ???consumers,??? ???health care providers,??? ???state and ANS??? employees??? and ???others??????according to the interests defended in the health care market. Data was collected from documents on the use of the agency???s social participation instruments of, such as attendance lists, meeting minutes, and public reports. Results indicate a more organized and consistent participation of ???private health insurance companies??? and ???health care providers??? on the regulatory debates held by the agency, while ???consumers??? show a more diffuse, less organized participation and are less likely to take part in technical councils and technical groups, instruments that provide technical approach to regulatory debates.