Both Brazil and the United States have distinct experiences with reforming their respective healthcare systems. While the two countries have different systems and have pursued different types of reform on different timetables, there are lessons to be learned by looking at the two countries side by side.
Major healthcare reform has already occurred in Brazil over the past couple of decades. It is possible to draw relevant parallels between some of those changes and what the Patient Protection and Affordable Care Act (ACA) includes for the United States.
There is much discussion about what will happen in the United States if the individual mandate is eliminated and underwriting remains prohibited. Taking a look at the evolution of Brazil’s healthcare system may provide some insight into this possibility and other possible outcomes of healthcare reform in the United States.
UPDATE (June 28, 2012): The United States Supreme Court has upheld most of ACA, including the individual mandate. This comparison between the results of Brazil’s healthcare reform and certain provisions of ACA clarifies the purpose of the individual mandate in the United States and describes how the individual mandate can help minimize adverse selection.