The financial protection impact of the public health system and private insurance in Brazil

This research assesses the effectiveness of the Brazilian public health system and of private insurance in Brazil in providing financial protection in health care. The determinants of catastrophic health expenditures are estimated by probit regressions with Heckman selection adjustment controlling for health-care need. Findings show that the public system provides a significant reduction (47%) in the probability of a household having catastrophic health expenditures, and that private insurance makes such expenditures more likely by 36%. Recommendations include improvements in the quantity, accessibility, quality and reliability of public providers, more appropriate provision of drugs by the public system and tighter regulation of private insurance.