Seleção adversa em planos de saúde individual: um estudo introdutório

Abstract

The purpose of this paper is to seek evidence of adverse selection in a portfolio of the individual health plan studied, and discuss the possible future problems that this kind of phenomenon could cause to health insurers, since after the regulation of this sector this problem became more frequent in the daily life of these companies. We have analyzed, as a way of comparison, the portfolio of a collective and an individual plan, both with co-insurance, and found evidence of a possible adverse selection in the individual portfolio. Statistical tests were used for making conclusions. By analyzing the frequency of hospitalization of the two portfolios it is noticed a different behavior of individual portfolio in relation to collective, noting an average utilization of inpatient higher in the first portfolio. One way to avoid this type of information asymmetry is the health plan operators to adopt a method of knowledge of your audience through guard against possible financial and actuarial problems caused by this mismatch of information.