Abstract
This article reflects on the future of the Brazilian Unified Health System (SUS, acronym in Portuguese), based on the foresight exercises conducted by the Brasil Saúde Amanhã initiative of the Oswaldo Cruz Foundation. The text briefly reviews some paths followed by the SUS as referred to in the Federal Constitution of 1988. It highlights the movement towards the decentralization of care and the constraint of health financial resources that reduced policies of increasing public expenditures. It examines the public and private arrangements for financing and provision of services that have resulted in sectoral privatization, mainly from economic policies articulated with concession of fiscal benefits. It analyzes the changes in the public sector financing through successive constitutional amendments that resulted in the weakening of established social protection policies, particularly of the health sector. For the future, the text considers population aging and analyzes trends in the epidemiological profile, with consequent changes in the health care paradigm. The article concludes by pointing out the consequences of fiscal strangling in the organization of the healthcare system and the need to reverse legal provisions that hamper the fulfillment of the constitutional mandate for equity and universality.
Highlights
Making prophecies about the future of human societies does not belong to the realm of scientific culture, whichever our understanding of what science is
This article reflects on the future of the Brazilian Unified Health System (SUS, acronym in Portuguese), based on the foresight exercises conducted by the Brasil Saúde Amanhã initiative of the Oswaldo Cruz Foundation
The physicist Michael Berry attempted to forecast the path of a snooker ball after it was hit
Summary
Making prophecies about the future of human societies does not belong to the realm of scientific culture, whichever our understanding of what science is. To predict the 56th, it would be necessary to include the effect of every single particle in the universe From another angle, the economist Prakash Loungani, Advisor at the International Monetary Fund, analyzed the accuracy of economic forecasters. The initiative adopted a set of basic principles that, according to Celso Furtado in his book Capitalismo Global (global capitalism), should underlie any long term national development plan for Brazil, where: the main goal of social action would cease to be the reproduction of the consumption patterns of the wealthy minority to be the meeting the needs of the whole population, and education be conceived as the development of human potential in the ethical, aesthetic and solidary action dimensions[5] This framework provides the basis for the ideas outlined in this paper
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