The challenge of organizing a universal and efficient National Health System in the Brazilian federal pact

Authors

  • Gabriella Morais Duarte Miranda Fundação Oswaldo Cruz; Centro de Pesquisas Aggeu Magalhães; Núcleo de Estudos em Saúde Coletiva
  • Antonio da Cruz Gouveia Mendes Fundação Oswaldo Cruz; Centro de Pesquisas Aggeu Magalhães; Núcleo de Estudos em Saúde Coletiva
  • Ana Lúcia Andrade da Silva Fundação Oswaldo Cruz; Centro de Pesquisas Aggeu Magalhães; Núcleo de Estudos em Saúde Coletiva

DOI:

https://doi.org/10.1590/s0104-12902017168321

Keywords:

Brazilian National Health System, Regional Health Planning, Government Financing

Abstract

Since the establishment of the Brazilian National Health System (SUS), important challenges remain to guarantee the right to health in the country. This theoretical reflection on the organization of SUS was based on interviews with social and health policy actors in the country, analysis of indicators related to municipalities, population, healthcare network and financing of the health system and from a critical yet not systematic foundation, guided by the conceptual framework of universalization, public oversight, financing of needs and decentralization of SUS. Universal health systems are considered as the most responsive to the population’s needs. However, underfinancing challenges their consolidation, with a nearly unchanged percentage of federal spending as a portion of gross domestic product (GDP), despite the actual growth of the total expenditure on health between 2000 and 2012, which reflects economic growth. A stability that does not respond to the growing needs of the health system. In Brazil, the federative pact and the organization of SUS based on the municipality, mostly with less than 30 thousand inhabitants, hinder the organization of health networks, compromising the system’s resolution, an understanding that reinforces the need for conformation of population-based territories. These are challenges that need to be addressed and that demand the recovery of the ideals of the Brazilian Sanitary Movement. The moment requires a resistance action, in defense of SUS, to ensure universality, unquestionably the greatest social achievement of the Brazilian population.

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Published

2017-06-01

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Section

Articles

How to Cite

The challenge of organizing a universal and efficient National Health System in the Brazilian federal pact. (2017). Saúde E Sociedade, 26(2), 329-335. https://doi.org/10.1590/s0104-12902017168321