Universalizing Health Care in Brazil

SUMMARY In 1988, the Brazilian Constitution established the Unified Health System (Sistema Único de Saúde, or SUS), based on universal access to health services, with health defined as a citizen’s right, and access to health services as an obligation of the state. Since then, Brazil has adopted a policy regime that combines both neoliberal policies— associated with those prescribed by the Washington Consensus or Bretton Woods Institutions—and more interventionist policies associated with neo-developmentalist thinking. The macroeconomic and social performance of this hybrid policy regime has been positive, insofar as the average household per capita income increased, and poverty and social inequality significantly declined. In the health sector, the capacity of the system with regard to health facilities and human resources has been expanded, while regional disparities in access to health services have been reduced. Access to primary health care has also been significantly expanded and health outcomes, such as life expectancy and infant mortality, have improved significantly. What steps did Brazil take to achieve universal health coverage, leading to substantial progress in economic and social development? Which institutions and actors have driven the universalization of health care within Brazil’s hybrid policy regime? (Por Ana Luiza d ́Ávila Viana, Hudson Pacífico da Silva, Ilcheong Yi)

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Universalizing Health Care in Brazil