The challenges of the SUS and public health in the world

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The Organic Health Law was responsible for detailing the functioning of the SUS and for defending joint action between federative entities, so that health is considered a fundamental right of the citizen and guaranteed in an equal and universal manner through public policies.


Currently, it is estimated that 75% of Brazilians depend exclusively on the SUS, while the rest of the population uses private healthcare – however, citizens who opt for a private plan still have the right to the public healthcare system.


Although the number of people dependent on the SUS is high and it has made numerous advances since its creation, its services are still not capable of serving the population with the desired quality and efficiency. One of the reasons for this is the fact that the system is underfunded and has had fewer and fewer resources allocated over the years. Other aggravating germany mobile database factors, such as Proposed Amendment to the Constitution 214/16 , which limits public spending on health to the previous year's value, adjusted for inflation, impede the system's evolution. Management failures as a whole, including issues related to corruption, contribute to the precariousness of the SUS, causing patients to wait for hours to be seen, find hospitals without enough beds and face long lines for appointments and treatments.


According to 2017 World Bank data, public spending on health in Brazil represents 48.2% compared to an average of 73.4% for countries that are part of the Organization for Economic Cooperation and Development (OECD). Compared to countries with similar economic conditions, Brazil is above the average among BRICS countries (Brazil, Russia, China, India and South Africa).


Despite this, the Brazilian system is still considered a reference in terms of free services and variety of services when compared to other countries in the world – being the only country with more than 200 million inhabitants to have a health system with comprehensive care for the entire society.


In the United States, for example, there is no universal health care system and people have to pay to receive care or to get medicine. In hospitals, citizens do not receive care if they do not have private health insurance. The American government subsidizes health insurance for some specific groups, such as the elderly and low-income people, but even for these groups, care and medicine are not free. China follows a similar model: there is no free public health care system. Public insurance is financed by employees, employers and the government and, in addition to helping to finance it, citizens have to pay fees for care and medication.


As for the countries that have a public and universal health system, such as the United Kingdom, Denmark, Sweden, Canada, Portugal, Spain and Cuba, none have a population above 100 million. Thus, although Brazil still faces difficulties in managing the Unified Health System – which brings to light social inequality and poverty and, therefore, fosters the need for public policies that can benefit all layers of society – it is undeniable that the Brazilian model is still one of the largest public health systems in the world.