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Health systems in transition
Portugal
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2.1.8 Private health insurance companies
On the financing side, the main private actors are the private health insurance
companies. VHI was introduced in 1978 (see section 3.5). Initially, only group
policies were offered, but individual policies have also been available since
1982. The number of people insured has grown from approximately 500 000 in
1990 to almost 2.7 million in 2015 (ASF, 2016). There is a mechanism of double
coverage in place, hence increasing mostly the number of specialized medical
appointments. People can even benefit from triple (or more) coverage, that is,
from the NHS, a health subsystem from their job, VHI and having coverage
from another health subsystem as an extension of their spouse’s coverage. It is
not uncommon for beneficiaries of health subsystems to also sign up to VHI.
2.1.9 Professional associations and unions
Founded in 1938, the Portuguese Medical Association (
Ordem dos Médicos
) is
the professional organization for physicians. There are also two main unions:
the National Medical Federation (
Federação Nacional dos Médicos
, FNAM)
and the Independent Medical Union (
Sindicato Independente dos Médicos
,
SIM). Membership of the Medical Association is mandatory for practicing
physicians. Its functions include:
•
accreditation and granting of licenses to practice
•
accreditation and certification of postgraduate medical training
•
application of the disciplinary code, with powers to warn and punish
doctors.
As for the unions, their main role is to advocate for physicians’ rights as
employees, mostly concerning wages and employment issues.
Equivalent bodies also exist for pharmacists (
Ordem dos Farmacêuticos
,
founded in 1972), dentists (
Ordem dos Médicos Dentistas
, founded in 1991),
nurses (
Ordem dos Enfermeiros
, founded in 1998), psychologists (
Ordem dos
Psicólogos
, founded in 2008), and nutritionists (
Ordem dos Nutricionistas
,
founded in 2010).
The National Association of Pharmacies (
Associação nacional de farmácias
),
a union for pharmacies, covers almost 95% of pharmacies, though membership
is optional. It has an important corporate role and operates as a fund, handling
the majority of pharmaceutical payments between the NHS and the associated
pharmacies. Its mission includes modernizing facilities and organizational
models; continuous education and training of pharmacists; dissemination