Health and equity

Abstract

In national and international journals, dedication to the subject of social medicine and interrelated issues, such as health equity, social and cultural determinants in health and access to health care, is still rather simplistic. In a scenario of global crisis, Europe and Latin America are facing a time where they must rethink their respective health systems, as in the case of the Unified Health System (SUS) in Brazil or the National Health Service (SNS) in Portugal, to find short, medium and/or long-term alternatives to reverse the problems arising from this crisis. The neoliberal policies implemented in recent years in Europe, particularly in Portugal, seem to move health systems away from equity. Thus, it is hoped that the World Health Organization (WHO) will fight against health inequities within a generation, ensuring a fair redistribution of power and resources to citizens so as to promote their health and well-being and, hence, obtain quality of life. The SNS (Portuguese National Health Service) is a structure through which the Portuguese State ensures the right to health to all its citizens. Its creation dates back to 1979, after having achieved the political and social conditions from the Portuguese political restructuring in the 1970s. The primary goal of the SNS is the State’s pursuit to fulfill its responsibility to protect individual and collective health. Therefore, it provides integrated health care which involves health promotion and surveillance, disease prevention and/or control, early diagnosis and immediate treatment of citizens, in addition to health rehabilitation for the purpose of work and social (re) integration. In recent years, the health sector has undergone significant changes since the overall transfer of the Misericordia Hospitals to the jurisdiction of the state, the creation of the SNS, publication of the Health Bases Law and transformation of the legal status of hospitals into corporations, and later into corporate public entities. The SUS in Brazil has been, since its inception, one of the pillars in the fight for equity, comprehensiveness and universal access of citizens to satisfactory care of their health needs, intended to foster health promotion, as well as reduce social costs with threats to health, and boost the rate of return of health services provided in adequate quantity and with undeniable quality. It is worth noting that during periods of political and economic crisis, there are those who advocate its privatization, which would result in the extinction of a policy emanating from the Federal Constitution of 1988, structured according to three guiding or building principles ‒ universality, comprehensiveness and equity. Universality ‒ “Health is a right of all”, as stated in the Federal Constitution. Naturally, it is understood that the State has the obligation to provide health care. In other words, all citizens have the right to access to health services according to their need.