SUS Brazil: The health region as a way forward

Abstract

The present article addresses the need to have regionalization of decentralization, in order to cluster together what this could supposedly have broken apart. On revisiting the constitutional guidelines on decentralization, the authors propose measures to provide assurance thereof, in addition to administrative tools that allow the formation of health regions to supply at least 95% of the health needs of the regional territory, to ensure sanitary independence. The authors suggest solutions that include the establishment of regional and associative corporate institutions resulting from the clustering of the federative institutes operating in the health area. The authors also state what has not worked out in the Brazilian National Health System (Sistema Único de Saúde - SUS), due to mistakes that have originated in the best of intentions, as also the opportunism that these mistakes have generated. The authors defend the need to bring judicial and administrative answers to a SUS that is interfederative in character, both in management, which requires some sharing, as also in financing which also remains interdependent. The conclusion reached is that the only way in which the SUS can be national is to regionalize it, and to give the health region all the instruments that are necessary for shared, interfederative and responsible management.