With all the controversy surrounding the Affordable Care Act (aka “Obamacare”) one thing is certain: healthcare is a hot topic. Opponents of a universal healthcare system have claimed that the United States offers the best healthcare in the world because it operates in a free market. It’s easy to take issue with that assertion, especially considering the exorbitant costs in the US healthcare system, but it certainly is a popular counterargument to government-funded healthcare.
For global context let’s take a journey south about 5,000 miles to Brazil. What is medical care like in Brazil versus the United States? This article will attempt to answer that question, bearing in mind that quality of healthcare can often be a subjective and tricky thing to nail down.
Healthcare for All
Healthcare in Brazil is a constitutional right, and the cost of providing quality healthcare falls upon the citizenry through a myriad of taxes. Brazilian citizens and government officials long ago conceded that healthcare for all citizens is a civic responsibility. So pervasive was this attitude that government-funded healthcare was written into the country’s constitution in 1988. Brazil’s system is referred to as the Sistema Único de Saude (Unified Health System) or SUS. The SUS itself is decentralized; municipal governments cooperate with the federal government in setting and enforcing healthcare policies. According to CNN, the SUS provides free primary care, surgery, medication, and a Family Health Program where doctors and nurses visit households to provide services.
A Mixed Bag
According to a new report by the World Bank, the hospital system in Brazil is of mixed quality. Some hospitals are “world class centers of excellence” that serve a wealthy minority who can afford private insurance. CNN echoes this point by saying that the rich municipalities (such as Sao Paulo and Rio de Janeiro) often have access to better technologies and medical infrastructure. On the other hand, most of Brazil’s hospitals are “substandard” and “deliver inefficient, poor quality care.” The World Bank report further goes on to state that “hospitals are a critical part of the government’s budget, absorbing nearly 70 percent of public spending on health.” With hospitals gobbling up the lion’s share of public funding on health, you would expect better than “substandard” care. But as is often the case with a geographic area as large as Brazil, it’s difficult to spread resources evenly and reach more remote locations where healthcare may be sorely lacking. An article in the Economist asserts that “SUS’s doctors reach only about half of the Brazilian population. Another quarter have private health insurance; and the remainder, mostly poor people, live in remote, rural areas or violent urban slums where the service is lacking.” The rural population must either pay out of pocket or take their chances in the emergency room.
To combat this problem, a number of private enterprises have stepped in to fill the void. Dr. Consulta, a clinic located in a slum of Sao Paulo, is pre-eminent among those private enterprises. According to Forbes, the average waiting time to see a doctor in Sao Paulo is three months; the average waiting time for Dr. Consulta is merely three days.
The story seems all too familiar. The government wants to do right and provide citizens with healthcare, but the system simply can’t handle the demand. The result is a hodge-podge of public and private services with varying levels of quality.
Byline
Trevor Clarence is fixated on health & wellness and often writes on hospital quality, urgent care, emergency rooms, the medical profession, medical science, health education and other related topics. To learn more about urgent care from a quality provider Trevor encourages readers to visit Prime Urgent Care.
Image credit goes to gaby_bra.