O Health Unic System, better known by the acronym SUS, consists of an important Brazilian public policy for health care for our population. The SUS is one of the few nationally integrated health systems (hence the characterization called the single word) and which offers universally free services. Anyone who is in Brazilian territory, regardless of nationality, condition socioeconomic status or any other distinguishing factors, they can turn to the SUS to obtain care services. the health.
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What is it, how does it work and what is the importance of SUS?
Health care is a problem faced by heads of state in all countries. It is necessary, for the stability of any government, that citizens have preserved their normal health conditions so that the economic indices and social indicators of a country stay high. Most countries do not have free systems that serve anyone, regardless of their socioeconomic status.
the SUS it serves low, medium and even high-income people free of charge, if they look for the services. SUS also serves foreign who are residing or passing through Brazil without any charge. One of the main characteristics of the SUS is the union of executive powers (Federal, state and municipal) by the system management, so we have services offered by the three levels throughout Brazil.
Thus, a centralized guideline for the management of the system is created, managed by the Ministry of Health, but management is decentralized at the ends of the system, which are in charge of the state and municipal health departments. There is a participation of the Ministry of Education in the management of SUS at the Federal level, since the university hospitals that make up the majority of federal universities that offer courses in Medicine and other areas of health receive resources from the two government folders in question: Health and Education.
You hospitalsCollege students they play an important role in the development of scientific research in the health area, in addition to serving as a field of action for students and offering free treatment to the population.
The resources that keep the functioning of the single system comes from the collection of taxes (at national, state and municipal level) which are directed to the Federal Government and return to the states and municipalities. Few countries in the world have a universal and free health care system like Brazil. The main ones are the United Kingdom, Canada, Australia, France and Cuba.
O modelBritish, established in 1948, served as an inspiration for our and works similarly. The British, Canadian, Australian and Cuban models are funded, as well as the SUS, by the governments, with the collection of taxes. In France, there is a type of compulsory health insurance for all people who are able to pay the fee. This fee supports the French system and allows people in a vulnerable situation (who cannot afford insurance) to also have access to the system.
Brief history of SUS
In Imperial Brazil, there were no official health management policies. There were doctors, hospitals and clinics that offered paid services and there were doctors and philanthropic hospitals, generally linked to religious orders, which served the population that was unable to pay for the services.
As the vast majority of people could not pay and the number of people who attended philanthropically was small, most of the population did not have adequate access to health care.. A good part of it even resorted to healers and, when it had a minimum of financial conditions, to pharmacists, formerly called apothecaries.
Due to the limited offer of free services and the bad sanitary conditions of Brazilian cities, people suffered constantly (and many died) with illnesses — some of them today considered to be simple to treat, such as worms, diarrhea, flu, tetanus and gonorrhea. The most serious diseases, such as syphilis, malaria and dengue, terrified the population even more.
THE first public health care policy in Brazil was promoted in the First Republic, at the president's government Rodrigues Alves, in 1897. That year, the General Directorate of Public Health was created, a body that, in 1903, was headed by the great Brazilian sanitarist Oswaldo Cruz. The measures focused on the federal capital, which was the city of Rio de Janeiro.
Oswaldo Cruz started a plan to organize the health of the capital, promoting compulsory actions, such as mandatory vaccination and inspection of private properties in order to eliminate mosquito breeding sites Aedesaegypt, which was already identified as a vector of yellow fever.
In addition to the campaigns led by Oswaldo Cruz, the mayor of Rio de Janeiro at the time, Francisco Pereira Passos, restructured the city, implementing a sewage system and a garbage collection system. The problem is that the restructuring remained in the downtown, where the tenements were. The tenements, crowded, cramped and unhealthy dwellings where the poor lived, were dissolved and the residents sent to the outskirts, transferring the problem there.
in 1923, after the great epidemic of Spanish flu, was created theNational Department of Health, which aimed to expand the sanitary measures inspired by Oswaldo Cruz's work throughout Brazil. There was still no offer of health treatments, only sanitary measures, such as the implementation of timid sanitation systems and vaccination campaigns.
this system was not funded by the government, but by a social security system that also offered workers linked to the private service regular retirement through the Retirement and Pension Funds. The National Health Department was linked to the Ministry of Justice.
in 1966, the National Institute of Social Security was created (INPS), which aimed to unify pensions and pension systems across the country. Private sector workers insured by INPS could use the medical service offered to them by the institute, but the plan did not last long due to the hiring of expensive private services to meet the workers. People who did not work with a formal contract and were unable to pay for private services were not assisted.
Already in the 1980s, after the end of Brazilian civil-military dictatorship, a process of restructuring of the federal democratic organization began. With the constituent Assembly and the enactment of Federal Constitution of 1988, there was also a concern to meet what was laid down in the document in relation to the right to health.
As the Constitution says that everyone has the right to medical and hospital care and health care, offered free of charge by the states, municipalities and the Federation, it was then a matter of creating a unified system that could meet to all. For this, on September 19, 1990, the Law 8080, which implemented and regulated the SUS in our country. There is also the Organic Health Law, which regulates the national guidelines of the SUS.
See too: Human Rights - category of rights guaranteed to all human beings
SUS principles and guidelines
The Unified Health System works in an integrated manner and operates Brazilian health throughout the national territory. The greater management and guidelines of the SUS come from the Ministry of Health, but the state and municipal health secretariats operate this management in their territories. The amount allocated to the SUS comes from tax collection, and the Union is responsible for passing it on to federal hospitals and state and municipal health secretariats.
![The SUS is an important public health care policy. [1]](/f/edcd559055d965cf6b0882f51deb228a.jpg)
SUS has principles for its operation. Are they:
Universality: all people have the right to medical, hospital and health care, regardless of any distinguishing feature, such as social class, nationality, gender, race etc.
Equity: treat with specificity and greater attention the most vulnerable people, who need the SUS more. In this sense, there are greater efforts to serve low-income populations, the elderly, people with special needs, people with chronic diseases, people with systemic diseases, patients undergoing cancer treatment, people with HIV, pregnant women, children etc.
completeness: it is understood that health care is not limited to the hospital or office, nor that it is necessary to wait for a disease to happen before a measure is taken. With this, the SUS also promotes educational campaigns that aim to bring information to people about personal care, food care, environmental preservation and sanitary actions that reduce the incidence of diseases in the population.
Also access: World Health Organization (WHO) – roles and achievements
Services offered by SUS
SUS is divided into different levels of health care for a better organization of work. In this sense, we have the primary or primary care, which acts in direct and regular contact with the population, carrying out consultations and home care visits, vaccination campaigns and awareness campaigns. THE secondary care it is offered to patients who have a diagnosed or suspected illness and need treatment or investigation by specialist physicians.
Heads uptertiary it is the one that supports the most severely ill patients who need hospitalization or intensive care offered in an intensive care unit (ICU) in hospitals. THE rehabilitation it is the follow-up and aftercare that the system offers for those who have already had an illness, but need assessments or even motor rehabilitation provided by physical therapists.
For the effective functioning of the four stages of service, we have specific locations so that the service is promoted in the best possible way. At basic health units (UBS) and emergency care units (UPA) support basic, comprehensive, and low-intensity health. They are places adapted to receive patients periodically for follow-up (UBS) and to treat less complex cases than need urgent care (UPA), such as dressings, first aid and emergency care for those who feel bad.
You hospitals they are reserved for the most complex cases, which generally require hospitalization or complex emergency care. They are taken to patients who have a serious or aggravated condition and need hospitalization, people who will undergo surgery, accidents, and people who need more complex exams.
The laboratories (which carry out specific laboratory analysis tests), medical research centers, such as the Oswaldo Cruz Foundation, and the university research centers, which seek to implement research on treatments, vaccines and the work of professionals in the health. Lastly, we have the SAMU, which is the Mobile Emergency Care Service, specializing in emergency first aid (first aid) and transportation of seriously ill patients to hospitals.
SUS problems
Like other essential public services in our country (education, sanitation and security), the Unified Health System faces several problems. The system itself and the laws and guidelines that govern it are excellent. The SUS is necessary, must exist and must be considered a reference in health management. However, the problems surrounding it, mainly from financial order and mismanagement, they make the service provided leave something to be desired.
There is a lack of hospitals and health professionals working in Brazil, especially in the peripheral regions of large cities or small towns, generally with the poorest population. THE lack of hospitals and health professionals in these places it is caused by the low investment of the secretariats in the construction of beds and the low remuneration of the professionals (doctors, nurses, nursing technicians, dentists and other hospital technicians) in these regions of greatest fragility.
There is also a excessive workload for working professionals, who work under stress, facing long journeys with an endless list of patients to care for. There is also a lack of essential specialized physicians, especially in areas with lower remuneration and greater workload. work, such as anesthesiologists, cardiologists, surgeons and intensive care physicians (physicians responsible for ICUs). With all these problems, many patients face a very long wait, which can result in aggravation of illnesses or even death, in urgent cases.
All of this may seem like a negligence of the medical class towards the population, but in the end it reveals a picture of the government's neglect of health care. There needs to be more investment and investigation of recurring cases of embezzlement of funds allocated to health for that SUS can, in fact, offer a dignified treatment to Brazilians, who deserve to enjoy the fair return of taxes paid.
Image credit
[1]Jo Galvao / Shutterstock
[2]Ministry of Health/Disclosure/ABr / commons
by Francisco Porfirio
Sociology Professor
Source: Brazil School - https://brasilescola.uol.com.br/sociologia/mas-que-seria-sus-quais-suas-diretrizes-principios-gerais.htm
