Brazilian Universal Health Care System.

What is the Brazilian SUS (Universal Public Health)?

Brazil has the largest universal public health system in the world. Sure China, India, USA and Indonesia have larger populations but none has a universal health system. By universal, Brazil means that anyone shall have health service regardless its social, economical, cultural, religion, color or origin (Brazilian or foreigner)! Brazil has one of the worse social differences in the world, we have several persons with a wealth into billion of US dollars and we still have millions into misery to take care! Our SUS has 165 million customers and an infrastructure that is not near enough but it has been improving in the last 12 years. These are the present number as found on the Health Ministry site: (http://cnes.datasus.gov.br/Mod_Ind_Unidade.asp?VEstado=00).

Some names may be confusing but it is due to bureaucracy and corruption that we have so many names!!

DISPENSARY	10.643
HEALTH CENTRE / UNIT BASIC	34.703
POLYCLINIC	6.229
GENERAL HOSPITAL	5.218
SPECIALIZED HOSPITAL	1.088
MIXED UNIT	726
PRONTO SOCORRO GENERAL	399
FIRST AID SPECIALIST	124
CONSULTORIO ISOLATED	134.921
MOBILE RIVER UNIT (Amazonian region)	23
CLINIC / CENTER SPECIALTY	36.235
SUPPORT UNIT DIAGNOSIS AND THERAPY (SADT ISOLATED)	20.870
LAND MOBILE UNIT	956
MOBILE UNIT LEVEL OF PRE-HOSPITAL IN THE AREA OF URGENT	3.518
PHARMACY	1.533
HEALTH SURVEILLANCE UNIT	1.851
COOPERATIVE	329
NORMAL CHILDBIRTH CENTER - ISOLATED	13
HOSPITAL / DAY - ISOLATED	525
CENTRAL REGULATION OF HEALTH SERVICES	296
CENTRAL PUBLIC HEALTH LABORATORY LACEN	64
DEPARTMENT OF HEALTH	5.539
CENTER OF ATTENTION AND OR HEMOTHERAPY (HAEMATOLOGICAL)	255
CENTER OF PSYCHOSOCIAL ATTENTION	2.444
CENTER SUPPORT FOR FAMILY HEALTH	778
UNIT OF INDIGENOUS HEALTH CARE	396
READY CALL	825
POLO ACADEMY OF HEALTH	941
TELEHEALTH	54
CENTRAL REGULATION MEDICAL EMERGENCY ROOM	215
DESK HOUSEHOLD ISOLATED (HOME CARE)	208
UNIT  UNDER ATTENTION RESIDENTIAL	12
WORKSHOP ORTOPEDICA	12
PUBLIC HEALTH LABORATORY	142
REGULATING ACCESS CENTRAL	545
TOTAL	272.630

Sure some numbers are quite short from what the IHO suggests as minimal or standard for such a large population but it has been improving steadily in the last 12 years! The entire Brazilian health system is much larger than these numbers because there is the private system which share or overlaps some of the above numbers! Remember that the top and upper middle classes in Brazil represents more than 45 million customers to a private health system! So you can imagine the level of services we have in Brazil if you have the money to pay for it!

Our middle class has systematically denigrated the SUS system on the local and international media. SUS is used by politicians to get elected and punish adversaries! Politicians themselves don't use SUS, preferring to use the first world class private health system. Surely it is immoral, but this is just one of many immoral behaviours of all Brazilian Politicians! (Here I will discuss the education in Brazil in the near future!).

The most incredible aspect of this systematic denigration of SUS is the fact that regardless of your social status YOUR LIFE DEPENDS ON SUS! You may be wondering How? If I have the best privet health insurance money can buy, How my life do depend on the public health system? Brazil is not USA, UK or Germany, so you may be driving alone on São Paulo or Rio de Janeiro and you have a heart attack! You crash unconscious and people call SAMU (the public ambulance service, first public health service saving your sorry ass!!) SAMU will take you to the nearest public health hospital (your health insurance card may be in your pocket but Who checks it??). You get into the public hospital and the emergency services kickin and stabilizes you! Now a nurse/hospital staff will look for ID and contacts on your mobile phone (if you put the first number on your contacts as AA emergency (Brother, sister, wife or someone that will know what to do in case of emergency) they will call using your mobile and tell what happened!). As you open your eyes, you are on a public hospital! SAVED! 

So all that bad thing you sad about SUS are not confirm because SUS has just save your sorry ass! You may be thinking that this scenery will only happen if you are alone! True! But how much time do you drive alone or with someone that knows what is your private health insurance and what to call in the case of an emergency? I bet this person will call the SAMU ambulance service and may say to take you to a private hospital! So public service still save your sorry ass! If you are driving on the countryside, there is no hope! All there is SUS or you are as dead as a Dudle!!!

So don't ask what SUS can do for you, but what you can do for SUS!

Middle class in Brazil has this strange behavior of denigrate all that is public or government related, but do not participate in the actual improvement of it! Middle class prefers to pay a private health insurance than to help to improve the SUS! It is personal choice, but I think it is time to review this position!

My next post will be on Health System in Brazil looking into mobile opportunities within SUS!

All the best,