The Collapse of the Brazilian Health Care System

This article was exclusively written for The European Sting by Ms. Anna Maria Andrade Barbosa, a second-year medical student at Pontifical Catholic University of Goiás, Brazil. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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The implementation of the Unified Nacional Health System (hereby SUS) according to the 1988 Constitution is a mark for Brazil as its reaffirms social security with a social protection system, articulating and integrating social insurance politics, social and health assistance, reaffirming the obligation of the State to provide universal, public and free health care at all levels of complexity under decentralized and participatory management. Thus, the relations that are established between the public system and the private health sector in Brazil come from the creation of SUS. As has been seen, the SUS remains in a relationship between the state dimension, which includes: hospitals, primary care networks, family health programs, and a private dimension contracted or assembled consisting of private services such as: clinics , laboratories and doctor’s offices, and for the services provided by health plans and insurance, the so-called supplementary health. However, when the private exceeded its limits to encompass organized economic activity around the market, while economic activities reach the public level, pertinent issues to the private sphere become collective interests and private interests take over. Also in the specific field of health in Brazil, the evaluative meaning of the two terms of the public-private dichotomy guided, at least in the recent past, the terms of the debate between advocates of health as a right, based on the recognition and criticism of a “ privatization of the public ”due to the penetration of private interests in the government sphere. This reality has come true because the SUS has since its conception suffered a chronic underfunding with the lack of unprecedented health inputs that condemns the country to a health, sanitary and social collapse. To illustrate this fact, if the PEC95 had been in effect between 2003 and 2015, the Union would have spent 42% less (257 billion) on public health actions and services. Public resources invested in health by the federal government in the post-coup year, in 2017, were only R $ 101.134 billion with an increase of 2.23% compared to 2016, when inflation of the year was 2.95%. What is vaunted by the authorities as economics actually represents the subtraction of rights. Given the current situation, the population needs comprehensive health care, which requires an increase in healthcare resources. It is important that we move forward in building a policy for the country that makes primary care strong, qualified, integral, longitudinal and resolutive, with universal coverage at all levels rescuing the constitutional fundamental rights of 1988. References ARRETCHE, Marta T.S. (1995), “Políticas de desenvolvimento urbano na crise: descentralização ou crise do modelo BNH?”, in Elisa Reis, Maria Hermínia Tavares de Almeida e Peter Fry, Pluralismo, espaço social e pesquisa, São Paulo, Anpocs/Hucitec. BRASIL.Constituição da República Federativa do Brasil: promulgada em 5 de outubro de1988. São Paulo: Saraiva, 2002. CHIACHIO, Neiri Bruno. Caráter público da gestão governamental com organizações sem fins lucrativos. O caso da Assistência Social. Dissertação de Mestrado, 2006. CORDEIRO, H. Sistema Único de Saúde. Rio de Janeiro: Ayuri, 1991. Fontenelle LF. Mudanças recentes na Política Nacional de Atenção Básica: uma análise crítica. Rev bras med fam comunidade. 2012 jan-mar; 7(22):5-9.ago. JACCOUD, Luciana. Proteção Social no Brasil: Debates e Desafios. Brasília, IPEA, 2007. SPOSATI,Aldaíza de Oliveira.Assistência na trajetória das políticas sociais brasileiras:uma questão em análise, 8.ed. São Paulo:Cortez, 2003. Vieira FS, Benevides RPS. Os impactos do novo regime fiscal para o financiamento do Sistema Único de Saúde e para a efetivação do direito à saúde no Brasil. Brasília, DF: IPEA; 2016 About the author Anna Maria Andrade Barbosa is a second-year medical student at Pontifical Catholic University of Goiás, Brazil. She is an avid reader with a love for travelling. Interested in understanding more than the science field and avid for a learning opportunity. She is a member of the IFMSA Brazil’s and it’s in the academic directory in the financial department.