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Brazil's health care system vastly expands coverage, but universality, equity remain elusive
Date:5/10/2011

lth system is made up of a complex network of complementary and competitive service providers and purchasers, forming a publicprivate mix that is financed mainly by private funds.

During the past two decades, the researchers noted, the SUS has undergone significant changes. Among these were granting municipalities greater responsibility for health service management, along with the flexibility and means which to bring about social participation in health policy making and accountability.

In the Lancet study, the researchers found vastly increased access to health care for a substantial proportion of the Brazilian population. In 2009 alone, the SUS financed about 12 million hospitalizations, delivered nearly 100 million ambulatory care procedures per month, and reached universal coverage of vaccination and prenatal care. It also expanded the supply of related human resources and technology, including enhanced production to meet most of the country's pharmaceutical needs.

But the researchers also observed that "the SUS is a health system under continual development that is still struggling to enable universal and equitable coverage."

"As the private sector's market share increases, interaction between the public and private sectors are creating contradictions and unfair competition, leading to conflicting ideologies and goalsnotably, universal access vs. market segmentation," they wrote. "All of this has a negative effect on the equity of health-care access and outcomes."

Further complicating the nation's goal of universal coverage are constraints on federal funding. While federal expenditures have increased nearly four times over the past 10 years, they added, the health sectors' share in the federal budget has not grown, producing constraints on financing, infrastructure, and human resources.

"The development of the Brazilian health system reflects the uneven process of social, economic, and political d
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Contact: James Devitt
james.devitt@nyu.edu
212-998-6808
New York University
Source:Eurekalert

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