Photo: EEC/Fiocruz/ Disclosure
The celebration of the International Day of Universal Health Coverage in Brazil means defending the growth of assets to finance the Unified Health System (SUS), which, regardless of being one of many largest in the world in phrases of inhabitants, continues to be inadequate.
This is the opinion of doctor Ligia Giovanella, senior researcher on the National School of Public Health (ENSP/Fiocruz) of the Osvaldo Cruz Foundation.
With in depth expertise in the sphere of mass health, she factors out that on this twelfth you will need to perceive the distinction between common coverage and common entry.
For the professional and member of the Center for Strategic Studies of Fiocruz, these two ideas of universality in health have intensified the worldwide debate in current years.
If the idea of common health coverage encourages differentiating health insurance coverage in line with a person’s capability to pay, a common health system has no definition of a restricted basket: companies should be supplied in line with the wants of the inhabitants.
“Comprehensive care is considered one of its tenets; Everyone ought to obtain consideration in line with their wants, not based mostly on benefit or earnings”, says Ligia.
The concept of common coverage has been integrated into United Nations (UN) resolutions, propagated by worldwide organizations such because the World Bank and the World Health Organization (WHO).
In Ligia’s understanding, this idea is doubtful, created by the connection between the WHO, the Rockefeller Foundation and the World Bank.
“In European international locations, universality usually refers to public coverage of nationwide methods, akin to underneath the designation Universal health care Or Universal health methods”, he explains.
The physician contradicts this idea. In growing international locations, the time period is used to cowl fundamental companies or health insurance coverage coverage, whether or not public or personal, “with an emphasis on demand for subsidies to the detriment of constructing common public methods”, he factors out.
Health coverage by sort of insurance coverage, whether or not public or personal, doesn’t assure entry to health companies as wanted, Ligia says.
“So, in Brazil, we defend the SUS, which supplies common entry to all residents dwelling in the nation. This is completely different from personal insurance coverage coverage that, in common, covers what’s in their contract, a fee that relies upon not solely on individuals’s capability to pay, but additionally on the health danger offered by the contractor”, he mentioned. emphasizes.
For the researcher, the personal system shouldn’t be supportive and doesn’t cowl all of the health wants of the inhabitants.
Sharp assault on SUS
Ligia remembers that the SUS funds has at all times been inadequate to deal with a common system. “It at all times was, nevertheless it nonetheless faces a extreme lack of funding with the constitutional modification (EC) 95, which must be repealed to ensure common care, common entry”, he factors out.
EC 95, the researcher continues, suspends public spending on health in such a manner that, even when a rustic will increase its earnings, it can not readjust its spending on health.
Which she sees as a paradox, because it’s an space the place prices are rising as a result of persevering with modifications in epidemiology and demographic profiles.
“Fortunately, the Brazilian inhabitants lives longer, however this additionally brings particular care wants for this group”, he thinks.
Despite all of the difficulties, the Brazilian system, as a result of its decentralization, via the initiative of governors and mayors, has proven all its worth throughout the pandemic, he highlights. “If it wasn’t for SUS, we’d positively have died extra and the inhabitants would have suffered extra”, he burdened.
shock and incapacitation
Although he’s not a part of the health transition group for the brand new authorities that takes workplace in January 2023, Lygia had entry to elements of the analysis that’s being accomplished in the approaching days.
“There is a collection of setbacks and all of the incompetence of the outgoing authorities’s health administration, which accounts for no less than half of the deaths from Covid in the nation”, he noticed.
According to her, the proposals are clear “in the sense of increasing SUS funding in order that we actually have a system that covers the wants of the whole inhabitants and may deal with all of the pent-up demand as a result of epidemic in phrases of entry, ready for some specialties and elective surgical procedures. alongside traces of sight; and permit us to broaden coverage and attain our strategy to main health care, such because the Family Health Strategy”, it lists.
Family health Universal
The household health technique, remembers Ligia, is now not a precedence in the Bolsonaro authorities.
“It must be a precedence once more, as a result of this care mannequin, with devoted multidisciplinary groups, exhibits outcomes with a really optimistic affect on the health of the inhabitants, in line with analysis”.
The professional lists examples, akin to decreased toddler mortality, decreased hospital admissions prevented by main care, decreased regional entry disparities and decreased entry disparities for the aged.