Andre Cezar MediciUniversal Health Monitor · I am researching in areas of Health Economy and Managerial Social and Political Aspects of the Health Sector
Andre Cezar Medici
PhD
I am developing research on health economics and related matters (currently in Covid-19 pandemics and ageing)
About
545
Publications
98,295
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Introduction
Mr. Medici is International Health and Social Economist in Washington DC. He was previously a Senior Health Economist of the World Bank (2008-2020) and IADB in Washington (1996 to 2008). Currently he is a consultant in subjects of health and social development worldwide. He also played an instrumental role in the planning, development, and implementation of the Unified Health System (SUS) in Brazil. Before 1996 he held several top positions in public and academic institutions in Brazil.
Additional affiliations
June 2008 - June 2020
Position
- Economist
Description
- Senior Health Economist, working in the Health, Nutrition in Population Area. Experience as task team leader and project leader in countries such as Brazil, Colombia, Peru and Bolivia. Also work as team member in Afghanistan, Pakistan, Bangladesh, Vietnam, Nepal and Nicaragua
June 1998 - June 2008
Position
- Teacher
Description
- Once a year I teached International Compared Health Systems in the Master Degree of Health Management
February 1983 - March 1992
Position
- Teacher
Description
- Teacher of National Accounts and Introduction to Economics in the Departments of Econmics and Sociology.
Education
March 1994 - June 1999
March 1978 - August 1979
February 1974 - December 1977
Publications
Publications (545)
There is evidence of persistent inequalities in household financial protection of health and drugs spending in Latin America. Despite the expansion of coverage, strong inequalities persist in access to health and family spending on drugs in the region. Out-of-pocket spending in medicines is regressive in greater need for affordable medicines.
This paper discusses some of the global trends and hits of the health sector along 2023 and explore some of the trends of these problems and issues for 2024.
This presentation explores and evaluates alternative models of
financing for advanced therapies and medicines intended for the treatment of
rare diseases, aiming to develop innovative strategies that promote equitable access to these treatments, financial sustainability of the health and the stimulation of research and development of new therapeuti...
Esta presentación describe las condiciones de salud mental entre adolescentes y jóvenes entre 10-19 años de edad en los países de América Latina y El Caribe, y presenta estimaciones de los costos indirectos asociados a estas enfermedades en 2019, en términos monetários y como porcentaje del PIB, demuestrando que las pérdidas relativas a las enferme...
This document analyzes the indirect costs of mental health for adolescents and young adults in Latin America and the Caribbean (LAC) region and its potential impact in lowering human capital in the region. It uses a broad definition of mental health conditions (MHC), classified into four components: neurological disorders (ND), mental health disord...
Minha apresentação se concentrou no tema da sustentabilidade do mercado de planos de saúde no mundo e no Brasil. Apresentei alguns desafios e dinâmicas que impactam a sustentabilidade desse mercado, entre eles: (a) as mudanças demográficas e o envelhecimento da população; (b) a tendência ao crescimento dos custos dos serviços de saúde, devido a ava...
Esta apresentação aborda 5 temas encadeados: (1) Doenças Emergentes e Inovação: Os Ensinamentos da Pandemia; (2)Compartilhamento internacional de informações sobre inovações em saúde; (3) Vigilância, detecção e gerenciamento dos riscos das inovações em saúde; (4) Capacitação dos países para avaliar a segurança e eficácia das inovações em saúde, e (...
This presentation contains the results of a survey about mental health financing in Latin America and the Caribbean Region during the Covid-19 pandemic, focusing on mechanisms of financing, payment mechanisms used for mental health and future perspectives
The presentation intents to discuss why the cancer mortality rates are still increasing and what are the efforts made to reduce the mortality and the perspectives for the next 10 years.
This presentation is focused on the trends and challenges of Ageing in LAC Health Systems, discussing possible early solutions to grant a sustainable health ageing through LAC health systems and some good practices on health to old age people
in LAC.
Aula proferida no MBA Executivo em Liderança e Gestão Pública na Saúde Módulo: Saúde Baseada em Valor, no Albert Einstein Instituto Israelita de Ensino e Pesquisa no âmbito do PROADI-SUS, Triênio 2021-2023
This presentation explored the following subjects: (a) the dimension of the health
markets in the Latin America South Cone Countries; (b) some trends of the health
markets in each of the South Cone Countries; (c) the existing underfinancing of health investments, and (d) the main market trends country by country for the next years.
This presentation describe a set or chronic problems and acute challenges faced by the public and private health systems in Brazil.
A aula se divide em 5 partes: (1) Conceitos Básicos de Mecanismos de Remuneração de Provedores de Serviços; (2) Mecanismos de Pagamento e Integração dos Cuidados e Gestão do Risco; (3) Modelos de Pagamento Segundo o Nível de Renda dos Países; (4) Principais Desafios para a Implementação de Modelos de Remuneração, e; (5) Modelos de Remuneração de Se...
Discute os conceitos básicos de V.B.H.C. e alguns aspectos específicos associados a sua implementação, risco e modelos de pagamento associados a valor
André Medici As reuniões do G7 de Maio de 2023, realizadas em Hiroshima-Japão, foram de grande importância para o alinhamento dos países ricos. As ameaças ao desenvolvimento, além de também estarem relacionadas à guerra da Ucrania, estão vinculadas ao contexto pós-pandemia do Covid-19. Neste sentido, seria impossível que esta reunião não se debruça...
This is a class for undergraduate students of Economics about health equity indicators with concepts and some examples applied to the Latin America context.
Along the first 100 days of the Lula government, the Ministry of Health announced the support to some well-known brand-named policies of the old Lula and Dilma Governments such as:
(a) The relaunch of the Mais Médicos Program with the perspective to insert by the end of 2023 around 28 thousand doctors in the Program.
(b) the creation of a nationa...
Este artigo foi publicado no Observatório da ANAHP, Edição de 2023, páginas 31 a 51.
O objetivo deste texto é analisar os fatores que tradicionalmente afetam as finanças dos hospitais privados e que podem dificultar o equilíbrio das receitas dessas entidades ao longo do ano de
2023. Para entender esse movimento, faz-se uma
análise em quatro seç...
This paper discusses the readjustment process of the private health insurance premiums in the private health insurance market in Brazil and the problems related which its public regulation.
Em 2023 ocorrerá um tsunami regulatório nos planos de saúde suplementar no Brasil, com prováveis impactos na cobertura, na qualidade e nos níveis de atendimento das demandas da população beneficiária. E fácil pensar que medidas como contenção dos valores dos prêmios por debaixo da variação dos custos ou aumento ilimitado de cobertura podem ser vant...
In mid-2022, Jeffrey Lazarus, professor at the Instituto de Salud Global at the University of Barcelona, and his collaborators, undertook, through a Delphi study, an effort to synthesize the state of the art and the perceptions of a panel with 386 international specialists (among them 5 Brazilians, including myself) on trends in the Covid-19 pandem...
This presentation summarizes de data and the performance of the Brazilian government along the Covid-19 pandemic and discusses some trends for the Brazilian Health System in the Post-pandemic context.
This presentation discusses the concepts of technical and allocative efficiency of health financing in Brazil and present data about changes in the efficiency score of technical efficiency of health financing of the public health spending in Brazil. It also discusses the main causes of inefficiency on health spending and propose some measures to im...
This paper describes the challenges to mesure direct, indirect and social costs of rare diseases and present some suggestions of policies to implement better criteria to measure these costs by government and civil society.
This presentation discusses the evolution of the telemedicine, the push of its utilization during the Covid-19 and its futures perspectives worldwide and in Brazil
Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 r...
Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic 1,2 . Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19...
Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 r...
Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic 1,2 . Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19...
This presentation discuss the advantages of the personalized medicine in the prevention, control and treatment of cancer and present the findings of a survey about the potential of implementing personalized medicine in 10 countries in Latin America
This presentation aims to discuss the process of optimization of patient flow in the hospitals as a key tool to improve technical and allocative efficiency in a hospital. The presentation evaluates the key aspects to improve performance of the patient flow regarding the use of resources (inputs, technology and workforce) and discuss the process and...
This presentation discuss what is the path to achieve two of the big challenges of the sustainability of the Brazilian Unified Health System: Lack of financing and Lack of Efficiency on the Funds Allocation
This presentation was done on the Workshop organized by the Fernando Henrique Cardoso Foundation (FFHC)
This post is the transcription of an interview I gave to journalist Rafael Machado from the Futuro da Saude website, on the topic of payment for services provided to Unified Health System of Brazil (SUS). If you are interested in seeing the article published by Rafael Machado (on August 26, 2022), just access the link: https://futurodasaude.com.br/...
Novas terapias vem trazendo enormes benefícios aos pacientes. Mas seus custos são
efetivamente muito maiores, necesitando de preços mais elevados do que os existentes nas nas terapias convencionais. Custos elevados se justificam somente quando há um
constante acompanhamento dos benefícios e um ajuste dos preços relacionados aos
resultados enco...
The atypical inflationary processes in years of strong fluctuation in demand for health services, as occurred with the pandemic, had strong impacts on fluctuations in the prices of health services and health insurance premiums in Brazil. In view of this scenario of uncertainties, ANS should review the individual premium readjustment formulas to mak...
Aunque la pandemia venga teniendo menos impacto en las economías, la guerra de Ucrania ha desatado una crisis humanitaria y fuerte daño económico que llevará a una desaceleración del crecimiento mundial en 2022, aumentará la inflación y la elevación de las tasas de interés. Los precios de los combustibles y los alimentos suben rápidamente, afectand...
Os processos inflacionários atípicos em anos de forte flutuação da demanda por serviços de saúde, como ocorreu com a pandemia, tiveram fortes impactos nas flutuações dos preços dos serviços de saúde e dos prêmios de seguros de saúde no Brasil. Diante deste cenário de incertezas, a ANS deveria revisar as formulas de reajuste dos prêmios individuais...
Objetivo: Este artigo discute questões relativas à eficiência e à sustentabilidade do gasto público com saúde no Brasil. A despeito das conquistas das últimas décadas, o Sistema Único de Saúde (SUS) enfrenta desafios estruturais com consequências no acesso aos serviços públicos de saúde e na proteção financeira da população. Métodos: O artigo traça...
Objective: This paper discusses issues related to the efficiency and sustainability of public spending on health in Brazil. Despite the achievements of recent decades, the Unified Health System (SUS) faces structural challenges with consequences on the access to public health services and on the financial protection of the population. Methods: The...
This is an interview about private heatlh plans in Brazil. The interview was done to Solange Monteiro and published originally in the blog of the Conjuntura Econômica, sponsored by FGV-IBRE. The link to the publication is:
https://ibre.fgv.br/blog-da-conjuntura-economica/artigos/e-preciso-atencao-formas-nocivas-de-concentracao-na-saude
This presentation analysis the international perspectives for the health sector in 2022 regarding the pandemic trends, the economic impact of the omicron variant in the perspectives and challenges for the health sector and its economic impact on 2022 and beyond.
The presentation discuss the perspective of sustainability of a new dimension for health technologies evaluation and details some of the key concepts and metrics to be used in this new approach
This paper discusses challenges and policies to address health in the context of population ageing. It reviews a wide range of data and evidence about policies and good practices based on work by international organizations, experts and country implementation experiences. It includes an analysis of how older people are addressing their health care...
Análise envolvendo o panorama dos casos e mortes mundiais por Covid-19, Análise envolvendo os quatro países com mais casos e mortes; Projeções e sub registro de mortes por Covid-19; Letalidade, Incidência e Mortalidade por idade e Variantes
This presentation discusses the evolution of ESG markets throughout the World along the last decades and discuss what are the perspectives and opportunities for the participation of Brazilian companies in ESG markets
This presentation shows the performance and sustainability of health institutions, particularly hospitals during the Covid-19 pandemic, in two phases: previous vaccination and after starting vaccination. The presentation compare the performance of US hospitals and Brazilian private hospitals (from ANAHP) and present, at the end, some interesting co...
This presentation discuss the economic burden and costs of cardiovascular diseases in the world and in Brazil
This is the entire version of an interview for the Magazine "Visão Saúde" describing what are the factors that impulse the needs of changes in the private voluntary health plans regulations in Brazil.
Variants have been the predominant way to increase Covid-19 transmission in late 2021. This presentation address the state of arts of the Covid-19 pandemic in September 2021 and discuss the presence of the delta variant and risks associated to this.
This article described the effects of the war against women in Afghanistan, describing how the principles of the extremist interpretation of the Sharia Laws created a huge gender inequality in health, education and other social rights. It describe also some improvements in the women social conditions along the 20 years period previous to the August...
This presentation discuss public health financing in Brazil from 2010 to 2021 and specifies some aspects of the financing of medicines and pharmaceuticals by the public sector in the country.
O 15 de agosto de 2021 ficará conhecido na história como o dia em que os homens do Talibã venceram a guerra contra as mulheres de seu país. As mulheres do Afeganistão tinham como pretensos aliados homens e mulheres em muitos países ao redor do mundo. Mas, depois de 20 anos tentando garantir a sustentabilidade democrática ao país, os Estados Unidos...
La presentación esta estructurada en tres capítulos: 1. ¿Es demasiado tarde o demasiado pronto para hablar del "después" de la pandemia?; 2. La respuesta de los sistemas de salud en ALC; 3. ¿Y después? ¿Qué se ha aprendido con la pandemia?
This presentation covers the following aspects: (i) Ageing trends in high and upper-middle income countries; (ii) Old age early mortality and morbidity; (iii) Access to health care for older persons; (iv) Financial protection to health in old-age; (v) Lessons learned on health policies to address older people’s needs, and (vi) Impact of the pandemi...
This paper evaluate the Brazilian position in world ranks of number of cases and deaths of Covid-19 as well as number of tests and vaccines applied in the Brazilian population. The original link to the publication is
https://monitordesaude.blogspot.com/2021/06/o-brasil-no-ranking-mundial-do-covid-19.html
O objetivo deste artigo é fazer uma síntese das análises de como os hospitais, tanto em nível internacional como no contexto brasileiro dos hospitais Anahp, têm enfrentado os problemas financeiros trazidos pela redução de atividades de rotina e pelo aumento de custos gerado pela pandemia. Busca-se conhecer quais fatores levaram os hospitais, no con...
This presentation analyses the trends of health sector price indexes in United States compared with the evolution of the costs of the health insurance premiums. The presentation also discuss the trends for 2021.
The U.S. healthcare system is complex, expensive, and unequal, creating difficulties for many to have access to the health services they need. But the struggle for health care coverage of the poorest Americans is part of the civil rights conquest, which was intensified along the reforms of the 1960s under the Lyndon B. Johnson government. Since the...
The purpose of this chapter is to provide an overview of the economic effects of the COVID-19 pandemic in its first seven months (March-September 2020) focusing the analysis on the countries that make up the G-20 and later on in Brazil. The chapter consists of four sections. In the first, an analysis of GDP growth estimates for the years 2020 and 2...
This presentation (in Spanish) includes the following topics: (a) health financing and services coverage in Latin America and the Caribbean (LAC); (b) LAC countries preparedness to tackle pandemics; (c) the cinematic of cases and deaths in LAC; estimated impact in the World Economy and perspectives to 2021; (d) estimated economic impacts in LAC eco...
This presentation shows the problems that private hospitals are facing to tackle with the Covid-19 Pandemic in United States and Brazil, discussing the facts and strategies used by these hospitals.
This is a brief introduction about how should be prepare contracting mechanisms to primary health care to local governments. It was presented to the Municipal Secretary of Porto Alegre Seminar
This short presentation introduce some aspects of telemedicine during the pandemic in Brazil and show some slides from a survey about how the private hospitals in Brazil (ANAHP system) are using telemedicine to increase access during the pandemic along 2020.
This is an interview to Solange Monteiro published in the blog of the "Conjuntura Econômica" - IBRE-FGV
Link: https://ibre.fgv.br/blog-da-conjuntura-economica/artigos/melhor-forma-de-conseguir-recursos-para-o-sus-e-garantir-que-o
This presentation explore the trends of Covid-19 pandemic, the expected economic impact in 2020 and 2021 and the economic policy used to face the pandemic effects in the World focusing in Latin American Countries
This presentation addresses the impact of Covid-19 in the Brazilian private hospitals and hospitals' emergency services, analyzing questions such as demand to surgeries, ambulatory services and hospitalization, as well as bed occupancy rates and financial aspects of hospitals performance. The presentation also discusses the economic trends and the...
A Saúde no Município do Rio de Janeiro é, em grande medida, um retrato do descaso dos governos estadual e federal e da má gestão da rede SUS ao longo das administrações passadas e, especificamente, da última administração municipal. As raízes dos principais problemas de cobertura da população e qualidade da saúde recebida da população do Rio de Jan...
This presentation describes the effects of the pandemic crises in the coverage of private health insurance, detailing the cases of United States and Brazil.
This presentation describes the costs of cancer in Brazil and discuss the challenges for its sustainability
This article describes the main determinants and implications of the government policy to fight Covid-19 in Brazil until the end of July 2020.
The main objective of this presentation is to discuss the optimization process of the health resources and information management as a pre-requirement to the implementation of value based health care payment systems.
Descreve os efeitos do Covid-19 nas receitas e gastos, na produção de serviços e no emprego de profissionais nos hospitais norte-americanos e elenca algumas medidas que estão sendo tomadas pelos hospitais para contornar a crise no ano de 2020.
The paper discusses the trends of the Brazilian and Latin-American Economy in 2020 associated to the trends of the Covid-19 pandemic until June 2020.
This is an introductory class about the economics of aging.
Questions
Questions (3)
Medical tourism has been considered for many countries as a gate to investment and attraction of foreign income. However, there are few evidences about its benefits to the health systems, specially in countries that still have a long way to achieve universal health coverage.
In the past, countries such as Cuba and some Caribbean Islands considered investments in health tourism as a way to increase trade of services and foreign income. However, I did not find any consistent analysis on the associated benefits, despite the fact that many countries keep discussing this as a good investment policy.
Many fragile states suffer with the lack of supply and demand incentives to spend efficiently the scarce sources used in public health systems, specially for primary care. If you have some experience that was evaluated and present good results (don't need to be national and could be regional or local) please share it. I am trying to collect these good experiences and summarize what should be the characteristics that assure higher efficiency in the use of funds in these fragile contexts.
Intermediate cities are increasing as in many development countries creating opportunities and better quality of life perspectives than megacities. However, the design of health networks and health insurance squemes that should grant good coverage and quality are still challenges. If you have some experiences to report based in evidence, please share the sistems designed, the solutions and the outcomes in order to identify challenge and factors of exit. Thanks.
