Brazil expat health care

Brazilian/American expat, husband, and father of three, John Sepulveda has worked in banking for more than 30 years. He has lived and worked in the U.S, Mexico, Brazil, and is now based in Madrid, Spain. We interviewed him about healthcare in Brazil.

1) What’s your opinion of healthcare in Brazil?

I would definitely not count on the public health system in Brazil. If you’ve followed events in Brazil over this past year you will have seen how people’s discontent with public services poured out into the streets, with crowds clamoring for more investments in public education, security and health care.

Waiting times are terribly long for those who depend on public health and only the most serious cases are tended to quickly. It’s not unusual for hospitals to be so crowded that beds are placed in the hallways. So I’d certainly recommend that anyone moving to Brazil buy private insurance.

As most insurers will put up obstacles to cover pre-existing conditions, sign up right away.  There are costly, elite insurers with the very best doctors, but you can also find relatively less expensive ones who still include good-quality doctors and hospitals.

2) What experience have you had with the public healthcare system?

The idea of universal health care in Brazil via the Sistema Unico de Saude or SUS is commendable, but its efficiency is light years away from the European public health systems.

Personally, I was fortunate to always be employed and so had private insurance. But we had housekeepers and maids at home who did depend on public health and their experience was generally poor.

One maid had excessive bleeding from what was suspected to be cancer of the uterus and she had to wait three or more months before surgery, with the risk that that wait implied. Another housekeeper had excruciating lower back pains and, instead of undergoing any exams, he was simply sent home with painkillers. In other words, no X-rays or MRI were given.

3) Tell us about private medical care in Brazil. How different is the standard of care across the country?

family health Brazil interview

With private doctors in Sao Paulo and Rio I have experienced both superior medical treatment but also some disappointments. I recall how many years back with a badly injured knee I was sent home with a cast when surgery was needed right away. Because of the delay, my leg atrophied 6 cms at the thigh and, as a result, the recovery was so much longer.  The physician, under the lower cost medical insurance I had, confessed that for what the insurance company paid it wasn’t worth their effort. But, on the other hand, the medical facilities and the physician that treated me for an appendectomy were both superb.

I would also note there are many examples of people who come from neighboring countries for treatment in world-class hospitals such as the Albert Einstein and Sirio Libanes in Sao Paulo.

4)Do staff speak English in private facilities?

The doctors may speak English, as participating in conferences/conventions or courses abroad is well regarded and shows that they are keeping up with new advances in their fields. Other staff, though, nurses or assistants, will rarely speak English.

5)Is private care expensive?

If you are not insured, private care can be costly, especially if you need more serious medical help. For a good doctor in Sao Paulo or Rio, it is not unusual to be charged R$400-500 (€130-€160) per visit, so you can imagine the cost of more specialized treatment. Definitely if you are moving with a spouse and children it is best not to pay out of pocket, as I guess is the case anywhere.

6)What would be your main piece of advice for expats coming to Brazil with their families in terms of health care?

Multinationals will invariably sign up their executives to the best private insurance available. It’s not unusual for local staff to have a lower type of coverage vs. what expats are provided with, and so expats generally do not have to worry about coverage.

However, if you are self-employed and setting up shop in Brazil, note that although more expensive,  the ideal coverage is the one that does not limit you to a list of doctors, but rather allows you to pick based on recommendations from others. Then you proceed to file a claim with your insurer.

Have you experienced health care in Brazil? Share your stories in the comments below!