In a continuation of her [previous post](http://healthmarketinnovations.org/blog/2011/jan/27/designing-low-cost-h...) about her interview with Ingrid Lins e Silva, Founder of [Saúde 10](http://healthmarketinnovations.org/program/sa%C3%BAde-10), Virginia Resende discusses what makes this low-cost, high performance primary health care chain unique, how the private sector can have an impact on the health of the poor, and more!
_VR: What makes Saúde 10 unique among other low cost primary care clinics in Brazil/Rio de Janeiro?_
ILS: There are many elements responsible for our sustainable competitive advantage. For one, we hired **effective managers**. Doctors are usually the entrepreneurs of popular clinics, but they usually do not have the competencies and the necessary knowledge to efficiently manage. A big problem in medicine schools in Brazil is that they do not offer management courses for medical students. Around 70% of doctors, dentists and veterinarians own their practices and cannot efficiently manage them. Saúde 10’s low-cost model requires technical planning, execution and control mechanisms. Our medical department manager is psychoanalyst and entrepreneur Dr. Paulo Issa.
Another point where we differ is in thinking a lot about **client perception**. Entrepreneurs starting high volume clinics don’t spend enough capital on real estate and office space decoration. We offer clean, well-illuminated, and convenient clinics. In addition to the physical aspects of the clinic, Saúde 10 trains staff to deliver respectful interpersonal services.
To ensure lower prices for patients, Saúde 10 is establishing **exclusive partnerships** with pharmacies, laboratories and examination clinics. Our clients have on average a household budget of one or two minimum wages a month (US$321 to US$635.) In macroeconomic terms, the most critical elements for us are the increase of purchase power of lower middle-class and aspirers (called class C and D in Brazil).
_VR: How do you think the private sector can have an impact on health for lower income people in Brazil?_
ILS: We believe that the private sector brings more professional services and management skills that impact directly efficiency and costs. By offering lower prices, access to healthcare increases to lower middle class and aspirers in Brazil.
_VR: How many other entrepreneurs in the area of health do you know, and who have succeeded in their business venture?_
ILS: I know cases of large companies focusing on upper income population (classes A and B in Brazil), such as [Rede D’Or, DASA](http://www.redelabsdor.com.br/). There are also successful laboratories like Diagnostika with very interesting business model and management that also cater to higher income clients. HiperCenter in Pernambuco is a great example of enterprise that makes a difference to lower income population.