The mother of a child with cerebral palsy spends about R $ 2,000 a week and regrets not being able to go to court: ‘Frustration’ | Sao Paulo
Carol’s son was 9 years old and was diagnosed with paralysis at birth. Since then, she has had to undergo therapy that helps her mobility, quality of life and avoid distortions.
Currently, the cost per session at a clinic is about R $ 250 Louis Henrik has to do eight sessions, he spends about R $ 2 thousand per week So, he planned to file a ban to reduce his costs, due to the clinic rejecting this plan.
“A session that costs R $ 250 to a reputable clinic, the insurance company was only returning R $ 29. It’s ridiculous. So, I was going to go to court, especially since the clinic was disrespectful. But the decision will not be. Therefore, anger also consumed the heart and frustration. And it’s a decision that affects everyone. “
The problem with the justice cited by Carol is that the ANS list was considered by most of the judiciary to be exemplary.
This meant that patients were denied procedures, tests, surgery and medications that were not on the list Can go to court and get this coverage because the listing was considered the minimum that the plan should offer.
Louise Henrique, 9, suffers from cerebral palsy and needs therapy every week – Photo: Personal Archive
The plan, therefore, should cover other treatments that were not on the list, but which are prescribed by a doctor, are fair and not experimental.
STJ understands now that role is complete. In addition, this list includes everything that plans need to pay for: If it is not on the list, it has no coverage and operators do not have to pay for it.
With change, court decisions must follow this understanding – there is no need to cover what is not on the list. In this case, many patients are unable to start or continue treatment with health plan coverage.
“From the moment you are diagnosed, you need to start treating the child so that the deformity does not occur. We also have problems with muscle stiffness which can cause deformities in the body. The treatments that are done are to maintain the quality of life, to avoid certain kinds of distortions. If left untreated, you can get scoliosis, a hip injury. It’s for life, ”he says.
Carol says that, like her son, there are children who need regular treatment and who are not always on the ANS list and are often unable to pay. Previously, guardians still received coverage or were compensated by a court decision.
“Sometimes, the child responds to general physical therapy, but there are other broad methods that give the child better stimulation and development. Seeing our stimulus, we have to look at all the methods. Of course, everyone has their time and their level. Treatment is important for everyone with a disability. ”
“So, we need to be aware of this [a decisão] It will affect millions of people. Unfortunately, we mothers live in a parallel world where no one observes what we do every day. We have no one to protect us, we have forgotten. It is very difficult for people to have an inclusive look, to have empathy. It’s not that people will feel what we feel, but that we should always put ourselves in someone else’s shoes. ”
“The more awareness, the more space we have. We are mothers who have to fight harder for their rights that government and non-government organizations do not bring to us. ”
Carol Viola talks about the decision to list the system listed by the National Complementary Health Organization – Photo: Personal Archive
Carol Viola and her 9-year-old son in S সাo Paulo – Photo: Personal Archive