Courts as healthcare policy-makers: the problem, the responses to the problem and problems in the responses

This article starts by analysing healthcare litigation in Brazil by means of a literature review of articles that contribute with empirical findings on this phenomenon. Based on this review, I argue that health care litigation in Brazil makes the public health system less fair and rational. In the second part of this article, I discuss the three most overarching responses to control the level of litigation and its impact on the public health system: (i) the public hearing held by the Supreme Federal Court and the criteria the court established thereafter; (ii) the recommendations by the National Council of Justice aimed at building courts’ institutional capacity; and (iii) the enactment of the Federal Law 12.401/11, which created a new health technology assessment system. I argue that latter is the best response because it keeps the substantive decisions on the allocation of healthcare resources in the institution that is in the best position to make them. Moreover, this legislation will make the decisions about provision of health treatments more explicit, making easier for courts to control the procedure and the reasons for these decisions.

O Sistema de Gestão do Ressarcimento ao SUS: análise de seu desempenho no período 2011-2014

O ressarcimento ao Sistema Único de Saúde (SUS), criado pela Lei n. 9.656, de 1998, apresentou resultados expressivos no período 2011-2014, em contraposição ao período 2007-2010. O presente estudo, de caráter exploratório, buscou analisar o ressarcimento ao SUS, sua origem, base legal, fundamentação jurídica, organização, funcionamento, desempenho operacional e efetividade, com foco nos resultados alcançados no período 2011-2014. Para isso, o autor apoiou-se em estudos anteriores, em documentos e relatórios oficiais, na legislação em vigor, nos acórdãos do Tribunal de Contas da União e nas ações ajuizadas perante o Supremo Tribunal Federal. As análises efetuadas indicam que os resultados alcançados nos últimos quatro anos são promissores, refletindo um cenário favorável à consolidação do ressarcimento ao SUS como um importante instrumento de regulação para o setor de saúde suplementar.

The effect of social security, health, demography and technology on retirement

This article studies the determinants of the labor force participation of the elderly and investigates the factors that may account for the increase in retirement in the second half of the last century. We develop a life-cycle general equilibrium model with endogenous retirement that embeds Social Security legislation and Medicare. Individuals are ex ante heterogeneous with respect to their preferences for leisure and face uncertainty about labor productivity, health status and out-of-pocket medical expenses. The model is calibrated to the U.S. economy in 2000 and is able to reproduce very closely the retirement behavior of the American population. It reproduces the peaks in the distribution of Social Security applications at ages 62 and 65 and the observed facts that low earners and unhealthy individuals retire earlier. It also matches very closely the increase in retirement from 1950 to 2000. Changes in Social Security policy - which became much more generous - and the introduction of Medicare account for most of the expansion of retirement. In contrast, the isolated impact of the increase in longevity was a delaying of retirement.

An evaluation of the Business Model Canvas by technology-oriented startups in Brazil : a qualitative study about the usage of the tool by Brazilian entrepreneurs

The following paper was conducted with the support of several entrepreneurs and startups from Brazil. The aim of the research was to find out which impact the Business Model Canvas, further abbreviated as BMC, has on technology-oriented startups in Brazil. The first step of the study was identify some general concepts of entrepreneurship, as well as the conditions and environment of the country. Afterwards, it was focused on defining and comparing different business model tools and concepts to the BMC. After the literature review and meeting with several professionals in the area of entrepreneurship and startups, a questionnaire was formulated in order to conduct the qualitative study and identify the main impact of the tool. The questionnaire was answered by ten startups. In order to check the validity and credibility of the research outcomes, theory and investigator triangulation was used. As a result, the usage of the BMC could be evaluated by obtaining the outcomes and the theory, which showed that Brazilian tech startups are using Osterwalder’s model for the reason of idea creation and testing, validating and pivoting their business model. Interestingly, the research revealed that the entrepreneurs are using the tool often not in the traditional way of printing it, but rather applying it as a thinking approach. Besides, the entrepreneurs are focusing mostly on developing a strong Value Proposition, Customer Segment and sustainable Revenue Streams, while afterwards the remaining building blocks are built. Moreover, the research showed that the startups are using also other concepts, such as the Customer Development Process or Build-Measure-Learn Feedback Loop. These methodologies are often applied together with the BMC and helps to identify the most sustainable components of the business idea. Keywords: Business