Are the SUS and the Right to Health Incompatible with Universal Health Coverage? Challenging Misconceptions around the Concept of UHC in the Public Health Scholarship in Brazil

Daniel Wei Liang Wang

doi:10.25091/s01013300202000030009

Abstract

ABSTRACT The literature on public health in Brazil has criticized the idea of universal health coverage (UHC), arguing that UHC is incompatible with the universal health system and the right to health. This article assesses that criticism and concludes that it creates a “strawman” argument. The idea of UHC that is being criticized in Brazil bears little similarity to the concept of UHC promoted by international organizations and discussed in the international literature.

Highlights

The literature on public health in Brazil has criticized the idea of universal health coverage, arguing that uhc is incompatible with the universal health system and the right to health
A filter was applied to limit the results to texts published in Brazil.The Scientific Electronic Library Online (Scielo) database offers a specific filter for this (“Collection: Brazil”), while in the bvs database the same can be achieved using the operator cp: “brasil”
Uhc is understood as offering a very limited notion of the rights of users and the duties of the state. They associate the universality of uhc with the idea of “packages” or “baskets” of services, two-tiered health care access, and financial protection against catastrophic expenditure via private health insurance. Universal health systems such as the Brazilian National Health System (Sistema Único de Saúde - sus) promote universal, comprehensive and integrated health care joined with equality and the recognition of health as a right that entails responsibilities for the state

Summary

Introduction

The literature on public health in Brazil has criticized the idea of universal health coverage (uhc), arguing that uhc is incompatible with the universal health system and the right to health. A literatura sobre Saúde Coletiva no Brasil tem criticado a ideia de cobertura universal de saúde (uhc) porque uhc preconizaria um modelo de saúde incompatível com o Sistema Único de Saúde (sus) e com o direito à saúde. Half of the world’s population lack access to adequate health services,and many must sacrifice a large part of their income in order to receive them, leading millions into extreme poverty (World Health Organization, 2019). In response to this context, several inter-

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