Brazil’s SUS National Health Problems

By Felicia Bryson, Contributing Reporter

RIO DE JANEIRO, BRAZIL – Following a study conducted by the Brazilian Institute of Applied Economic Research (IPEA) in February 2011, on the quality of services provided by the SUS (Brazil’s national health system), a series of investigations undertaken by newspaper O Globo have since revealed fraud and corruption within the Ministry for Health.

Between 2007 and 2010, irregularities of R$662.2 million (around US$412 million) were found in the National Health Fund. However, as only 2.5 percent have to be recorded in accordance with the Comptroller General’s Office (CGU), the governmental body in charge of auditing and inspecting public funds, the damage could be much higher than known to the public.

The scale of criminal misconduct is widespread and includes shopping, over-billings and cheating the system by hiring the same doctor in 17 different practices simultaneously, although the individual notified the ministry to denounce the misuse of his name.

In one case in Paraíba, the medic Godfrey Borborema was accused of abusing the system by creating a scheme in which he and three others charged patients for surgeries that had already been paid by the SUS. Surrendering on March 14, none went on to be sentenced for the extortion, although further investigations are said to be underway, as O Globo reported.

General discontent with the public healthcare system however, has been evident over the years as Brazilians have complained about the low quality of service provided. According to the IPEA study 30.4 percent of those who used the public system at least once in the last 12 months approved the SUS, while 27.6 percent of patients labeled it bad. A further 34.3 percent of those who only use private care also gave it a negative rating.

The main problem agreed on, is the lack of doctors and the long waiting times in order to be seen or get an appointment, which the government has now been forced to address through the demystification of public services so that funding can be traced all the way to its final destination.

“Improved access must be the central element in planning and coordinating all actions in the area of health, ” Health Minister Alexandre Padilha made clear last week.

The Head of the CGU, Jorge Hage also commented on governmental opacity, “Education and Health are the least supervised areas. In the Health department, there are major flaws in the control by the Ministry of Health in relation to resources from fund to fund. We attribute this to the lack of transparency in proper monitoring on behalf of the transferring power (federal government).”

President Dilma Rousseff reminded the public last week that improving the National Health System has been her party’s goal. “In the next four years we must make a huge effort to continue expanding access to health and transform the NHS into a system of high quality that takes responsibility for every Brazilian. It is a challenge and we are here to face challenges,” she said.

The 1988 constitution and the Organic Health Law (Lei Orgânica de Saúde) of 1990 was implemented in order to give all Brazilians the right to medical care by unifying the public health system, and to decentralize the management and organization of health services from the federal to the state and, especially, municipal level.