ACTORS INFLUENCE IN THE DEFINITION OF INSTITUTIONAL LOGICS: AN EXAMINATION OF THE PRIVATE HEALTH PLANS’ EXPENSES

Resumo (EN)

The definition of which expenses can be incurred in the private
health field is an endeavor that involves a dispute between multiple
logics. Private health operators in Brazil complain that medical
expenses have increased during the last decade in Brazil, as do
beneficiaries, who bear the fee readjustments that ensue. The study
analyzed how the actors in the private health field influence the
configuration of health care expenditures and the elements that
interfere, identifying a model of institutional logic that best expresses
these definitions in the field. The research is explanatory using
archival data and interviews with executives of the organizations in archival data and interviews with executives of the organizations in
the field. The results showed that the logics compete in the field with
a discourse in which each actor understands that the others are
responsible for the increase in expenses, and are against data
disclosure and transparency to safeguard market competition. This
case shows a coalition that is able to exercise its power to manipulate the readjustment of fees, because other actors will rather avoid
confrontation in an alternative that does not solve the problem about
the sector’s expenses, even with the acknowledgment that it is
becoming unsustainable.