In Brazil Health Care Is Universal: 10% Like It, 61% Call It Bad or Terrible

SUS, Unified Health System Brazilians have a public health system called SUS (Unified Health System). It is a formidable structure in paper: universal health care for every Brazilian, free of charge, from the cradle to the grave. Public hospitals and doctors who are civil servants. On paper it looks really good and it is in the constitution.

But, an opinion poll by Ibope, a traditional Brazilian pollster, at the request of  the National Confederation of Industry (CNI), found that the majority of Brazilians are not happy with their universal public health system.

The Ibope/CNI poll interviewed 2,002 people around the country and found that 61% of them said the Brazilian public health system was bad or terrible. Only 10% of those interviewed said it was good or excellent.

There were some regional variations. The system got its best marks in the south, where 30% of those interviewed said the quality of care they got was good or excellent. However, in the northeast, 62% said the quality was bad or terrible.

Asked if they saw any changes in the system, 42% of those interviewed said they saw no improvement, while 43% said it was getting worse.

Many of those interviewed mentioned the vaccination campaigns by the government, saying they were the most visible aspect of the system.

Among those interviewed, 24% had private health plans, most of them paid in part by employers.

Corruption

Problems in the Brazilian public health system (doctors on strike, equipment and material shortfalls and, once in a while, someone dying in line waiting to see a doctor) could be resolved if corruption was eliminated. At least that is what 82% of those interviewed believe.

Only 4% of those interviewed said they think that the government should increase taxes in order to get more funds for the public health system.

The poll found that 96% of those interviewed had used either the public or private health systems at some time and 61% said they had done so within the last 12 months. Out of those, the majority, 79%, got outpatient treatment at a public hospital.

When asked to grade, on a scale of 1 to 10, public and private hospitals, interviewees gave the public system a grade of 5.7, and the private system 8.1.

Asked how the public system could be improved, 57% said there should be more doctors, and 63% said they favored privatization of the public system, transferring the management of public hospitals to the private sector, believing it would result in better quality of treatment.

As Brazilians are notorious for self-medication and negotiating medications with pharmacists (instead of making an appointment with a doctor), it was a surprise to the pollsters that 84% of those interviewed said they were in favor of a recent government measure to control the use of antibiotics that requires a copy of a prescription for antibiotics to be left at a pharmacy so that there is some control.

Interestingly, 71% of those interviewed said they considered preventive medicine more important than the construction of hospitals.

A large majority of those interviewed said generic medicines were as good as famous brand name medicines and 80% said natural childbirth was better than a cesarean section (although Brazil has one of the highest rates of cesarean sections in the world).

The poll found that people with higher incomes or higher levels of education had more strongly negative opinions about the public health system. Negative opinions were also more prevalent in larger urban areas (cities with over 100,000 inhabitants) than in rural areas or smaller cities. Finally, women were slightly more negative about the public health system (55%), than men (51%).

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