Health Care in Brazil

The Brazilian health system is composed of a large public, government managed system, the SUS (Sistema Único de Saúde) , which serves the majority of the population, and a private sector, managed by health insurance funds and private entrepreneurs.
The public health system, SUS, was established in 1988 by the Brazilian Constitution, and sits on 3 basic principles of universality, comprehensiveness and equity. Universality states that all citizens must have access to health care services, without any form of discrimination, regarding skin color, income, social status, gender or any other variable.
Government standards state that citizen's health is the result of multiple variables, including employment, income, access to land, sanitation services, access and quality of health services, education, psychic, social and family conditions, and are entitled to full and complete health care, comprising prevention, treatment and rehabilitation. Equity states that health policies should be oriented towards the reduction of inequalities between population groups and individuals, being the most needed the ones for whom policies should be first directed.
SUS has also guidelines for its implementation, the most peculiar being popular participation, which defines that all policies are to be planned and supervised directly by the population, through local, city, state and national health councils en conferences. This is regarded as a very advanced form of direct democracy and has established the guidelines for many similar initiatives in sectors other than health all over Brazilian society.
The level of public spending is particularly high in relation to GDP for a country of Brazil’s income level and in comparison with its emerging-market peers. Government outlays on health care alone account for nearly 9% of GDP, the second largest item of spending following social protection. In health care, a number of conventional output indicators are not out of step with OECD averages. Following the decentralisation of service delivery in the early 1990s, increasing emphasis has appropriately been placed on enhancing preventive care. But, in a decentralised setting, cost-effectiveness depends a great deal on the ability of service deliverers to exploit economies of scale and scope. Experience with inter-municipal initiatives for procurement, as well as flexible arrangements for hospital administration and human-resource management, is by and large positive.
Private Health Insurance is widely available in Brazil and may be purchased on an individual-basis or obtained as a work benefit (major employers usually offer private health insurance benefits). Public health care is still accessible for those who choose to obtain private health insurance. As of March, 2007, more than 37 million Brazilians had some sort of private health insurance.