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publicado em 16/04/2013 às 13h57:00
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Where has the dream of SUS?

 
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Foto: CEBES
Ana Maria Costa, president of the Brazilian Center for Health Studies - CEBES.
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Ana Maria Costa, president of the Brazilian Center for Health Studies - CEBES.

After so many failed promises of redemption of the public health care network, the tendency of rulers seeking to respond to demands for health within the limits of their mandates have increasingly been delegating state functions to private enterprise. This inclination not reversed privatization and even eased the difficulties of the population framework to access and use health services.

In the documentary Sicko, Michael Moore, to be approached about the end of the hypothetical universal health care system English, NHS, one of the interviewees was blunt: there would be a revolution. British national pride, honored at the opening ceremony of the London Olympics, the NHS has always inspired the Unified Health System (SUS).

But, after all, where did the dream of SUS public universal coverage that would not, by definition, any person without regard to health? At the same time that citizens should fund the system through taxes, according to ability to pay, they could access it as needed for health, not on the basis of ability to pay or their inclusion in the formal labor market. In the dream of so many, enrolled in the Brazilian Constitution, the SUS would be the expression of solidarity that unites all Brazilians, rich and poor, healthy and sick, living centers or trenches in collective response to the essential human, health.

In Brazil, where the universal social policies have not come to consolidate the SUS succumbs to pressure from betting on privatization, coming from both sectors located to the right and left of the political spectrum-partisan.

The privatization of health care has always been concealed in the country, which contributed to the delay of a clear definition about the place that the community must rely on the private sector.

During the return to democracy, the constitutional process, the conservative platform of private business groups was confronted with the reformist agenda of the health movement. The prevailing conception of public health relevance, but the label has housed complementary private business segments of distinct natures and skills.

A quarter-century later remains confusion around the false unanimity in defense of SUS, rebuilt in the surf after the defeat of the Constitutional Amendment 29 and the current campaign by 10% of the Union's resources for health. The flag flutters for more public resources also from the perspective of accounting private groups and corporate interests, which historically never placed beside the extended social protection.

After so many failed promises of redemption of the public health care network, the tendency of rulers seeking to respond to demands for health within the limits of their mandates have increasingly been delegating state functions to private enterprise. This inclination not reversed privatization and even eased the difficulties of the population framework to access and use health services.

Take the example of the city of São Paulo: even given largely to the private sector, the municipal health exhibited at the end of 2012, the queue of over 660 000 requests for consultations, exams and surgeries. Add in the fact that 60% of São Paulo suffer at the hands of health plans and an exclusive private network collapsed, saturated and unable to provide proper care.

We arrived in Forqueadura. Nor can glimpse the SUS as a single system of quality, nor is there the prospect of heading to a health model predominantly private, made the American, Chilean and Colombian.

The impasse is the inversion between health needs and use of public fund. Brazil has a universal public system, but are private, for the most part, the resources allocated to health. There is a disconnect between the formal egalitarian values ​​and social practices of appropriation of concrete assistance resources, a totally incompatible with the realization of universal health policies. While in European countries and even the United States, the share of public health spending only increases in Brazil are witnessing the growth of private expenditure as the intensification of incentives for privatization.

In 2013, at age 25 of the 1988 Constitution, there is much to be celebrated. The precepts of the legal system has not foundered during the neoliberal tsunami due to ongoing resistance of social movements opposed to changes in the constitutional text. However, water has exceeded the expectation of neoliberalism by structural reforms in health, starting with the denial of the so longed new features that come with federal regulation of EC 29.

To this day, remain enigmatic arguments that have convinced the government coalition in Congress not to extend NHS financing. Admittedly, at that time, allegations of corruption and ill-fated attempt to tow the extension of the CPMF health created a climate unfavorable to increase public spending. However, none of this would justify the cowardly position of progressive parties.

The legislation unfavorable outcome after proceedings dragged for 12 years, left social movement organizations ear standing. So it was no great surprise disclosure by the press of a meeting between President Dilma Rousseff, ministers and business health plans in March 2013 to address the increased subsidies and tax exemptions for the market expansion assistance extra medical.

The news was swift and unanimous reaction in defense of SUS dozens of entities as CEBES, Abrasco, CUT, CONTAG, professional advice and the Commission on Social Security and Family of the House of Representatives. Possibly the contrary position even social sectors that supposedly represent future candidate for private health plans for workers and social segments which amounted in income pyramid, stunned fundamentalism.

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   Palavras-chave:   Public health care network    SUS    Health services    Public coverage    Ana Maria Costa   
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