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Governos de Lula e Dilma enfrentaram boicote de forças conservadoras e fortaleceram o SUS

Saúde pública universal e de qualidade é consenso na sociedade, certo? Tese defendida e apoiada por todos... Na verdade, não é bem assim. Em dois momentos dos governos Lula e Dilma forças conservadoras se uniram para derrubar propostas que garantem mais recursos e ampliam o atendimento médico em áreas e cidades desassistidas: a Contribuição Provisória sobre Movimentação Financeira (CPMF) e o programa Mais Médicos.

Médicos estrangeiros garantiram atendimento de saúde em localidades de todo o Brasil que estavam desassistidas Foto: Divulgação/MDS   

Derrotando o governo no Congresso Nacional no final de 2007, essas forças conservadoras conseguiram acabar com a CPMF. Da noite para o dia, foram retirados do Orçamento da União R$ 40 bilhões anuais. Eram esses os recursos que o imposto de 0,38% sobre os cheques provia ao Sistema Único de Saúde. O objetivo da oposição era atingir o presidente Lula e enfraquecer o seu governo, para derrotá-lo nas eleições de 2010. Mas quem pagou a conta foi o povo, a saúde do povo.

Seis anos depois, uma nova investida tentou inviabilizar o programa Mais Médicos, preparado para dar aos brasileiros mais pobres o acesso aos médicos que a classe média e os ricos sempre tiveram. O preconceito e a mentira se uniram para, vejam só, atingir Dilma às vésperas das eleições de 2014. E, mais uma vez, as vítimas foram as camadas populares. Aquelas que mais necessitam de uma saúde pública inclusiva e de qualidade.

Mas nem Lula nem Dilma se curvaram às pressões. O resultado é que, mesmo sem a CPMF, nunca se investiu tanto em saúde no Brasil como nos 13 anos de governos petistas. Os investimentos em ações e serviços públicos de saúde cresceram 86% acima da inflação, passando dos R$ 64,8 bilhões investidos em 2003, no primeiro ano do governo Lula, para R$ 120,4 bilhões no último ano do governo Dilma. Além disso, o programa Mais Médicos virou realidade e beneficiou 63 milhões de brasileiros. 

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More Doctors extend Family Health services
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The 14,000 professionals hired through the More Doctors program through May 2014 came to strengthen the basis of primary health care in Brazil: the Family Health Strategy, bringing to over 34,000 the number of teams prepared for the daily monitoring of the health of populations on the peripheries of large and medium cities and in small municipalities in the backlands of the interior.

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Commitment to investments in SUS
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Opponents could not imagine that the government's reaction to the end of the CPMF was exactly the opposite of what they expected: the Ministry of Health boosted funding for the area, expanding programs to improve primary care, investments in emergency departments and the distribution of medicine to prevent chronic disease.

In the last decade, health care activities have become part of a social inclusion strategy for millions of Brazilians from all corners of the country.

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Você Sabia?
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Hiring foreign doctors is common in other parts of the world

The recruitment of foreign doctors to work in first world countries is commonplace, especially those whose public health systems are points of reference. In England, 40% of the physicians are from other countries; Canada, 17%; in Australia, 22%. The United States has a private system in which 25% of the doctors are foreigners.


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The pre-salt operations will provide more investment for health services

Funds for Health will grow more in the coming years with the allocation of 25% of the pre-salt royalties and 50% of the budget amendments going to the sector. It is estimated that the amount of Health funding will reach R$ 84 billion in 2014 and rise to R$ 147 billion in 2018. This is an increase of more than 75%.


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Want to learn more?
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• Read the interview of former Health Minister, Alexandre Padilha, in the Revista Fórum magazine. [20]

• Brazil has fewer doctors per capita than Argentina and Uruguay

Before the creation of the program, there were states with only 1.8 doctors per thousand inhabitants. Worse: 22 states had even lower averages. In Acre, Amapá, Piauí, Maranhão and Pará, the proportion was less than one doctor per thousand inhabitants. To get an idea of what this means, in Argentina there are 3.2 doctors per thousand inhabitants. Compared with Uruguay (3.7 professionals per thousand) the deficit is even greater.

• Foreigners do not take jobs away from Brazilian professionals
Most of the foreign doctors in the More Doctors program do not take the place of any Brazilian doctor. From 2003 to 2011, 147,000 formal jobs positions were created for doctors in Brazil. In the same period, 93,000 new professionals entered the labor market. That's because the government increased vacancies in medical courses by 62.8% and quadrupled the offer of grants for medical residencies in strategic areas of the NHS in the last ten years.

• Ask questions about the program and be vaccinated against misinformation [20]

• Mayors recognize thrimportance of More Doctors: 

• Registered professionals want to help those who most need it: 

• The “the worse it is, the better” strategy failed
Upon defeating the CPMF — eleven years after it was created to fund health in the previous government — the opposition expected that investments in healthcare would decline and health care would deteriorate. But that did not happen because, despite the difficulties created by opposition, the government boosted the funding for the sector. This effort resulted in increased aid to philanthropic hospitals and a reduced backlog in SUS procedures.

• More resources for Public and Philanthropic Hospitals
With 41% of hospitalizations and 37% of beds funded by the SUS, the Santa Casa Hospitals and other Philanthropic Hospitals saw a 185% increase in federal funds to promote care of the poor, with transfers of R$ 970 million in 2012. There was also an increase from 26% to 50% for payments for exams and medium or high complexity surgery. To refinance the institutions’ obligations to the Social Welfare Fund, FGTS and a Federal Tax debt of R$ 15 billion, the government determined that they increase SUS consultations by 5%, paying taxes on time on a current year basis.

• SUS procedures up by 3,673%
The remuneration of doctors, labs and hospitals that serve the SUS system never increased as much as they have during the Lula and Dilma administrations. Some procedures — exactly 14 — have been readjusted upwards by 3,673% since 2003. To understand what this means, from 1994 to 2002, only four procedures were adjusted by 132%. That was the maximum in those eight years. In 2013, in addition to increases in the procedures rates, 11 surgical interventions for treatment of cancer began to be covered by SUS. The last change for SUS oncological procedures had occurred 20 years previously, in 1993.

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Palavra do Lula
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Overthrowing the CPMF was an act of insanity of the PSDB against people's health

"When in 2007 they overthrew the CPMF, it was an act of insanity of [the PSDB] against my government. They did this thinking it would hurt me in 2007. It was a CPMF fee of 0.38% on every check people wrote. And they did this not because of the amount. They did it to the CPMF because it allowed us to monitor and prevent tax evasion ... What was the idea? We’ll hurt Lula. He’s going to fail. Well, it was they who failed because I finished my term with an 87% good and excellent rating. Who did they hurt? The people."


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Palavra da Dilma
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Dilma’s comment: More Doctors resolve the problem

"What we want with this is to solve an emergency and an urgent problem, because people’s health can not wait for doctors to be trained. Hence, we are bringing in doctors from abroad. Simultaneously, we are going to increase the training of doctors in Brazil, ensuring they are trained to work in the interior of the country and on the outskirts of big cities."


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Palavra do Povo
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Marsália Xavier (GO) The best present that…

"It does no good to have a good house, a good car, earn well if your health is poor. Without health you can’t eat, work, you can’t even live. I think life is health. I think the best gift that government is bringing us is health."


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Jailson Barbosa, retired, Salvador/BA

"I had a pre-infarction and these free medicines are helping a lot. They’re already facilitating. They cost R$ 6.90 here. I’ve already saved R$ 4.00 because if I were in another pharmacy would have spend more than R$ 10.00. That money goes toward something else."


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Maria Helena, Community Health Agent, Igarassu/PE

"My job is to get information to the population. I check the kids’ cards to see if their vaccinations are up to date, I talk to every woman who is pregnant, with the elderly who sometimes are in bed in need of a medication or the care of a doctor during a home visit. This is the work of a health agent. We work in prevention. "


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Source URL: http://www.brasildamudanca.com.br/en/node/1566

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