A defesa do SUS depende do avanço da reforma sanitária

Abstract

COMUNICAÇÃO SAÚDE EDUCAÇÃO Defending the SUS depends on advancing health reform Over the years, I have become more and more convinced that the Brazilian National Health System (SUS) as foreseen by the constitution is better and more generous than Brazil. Without doubt, this is a paradoxical deduction, in so much as the SUS was idealized and is being implemented in the same contradictory, old and eternal country of the future, which, apparently, has never reinvented itself. So much so that, despite the fact that much has been accomplished and the positive impact of the SUS on the health and life expectancy of the Brazilian people, the concrete SUS-the "actually existing" system-still has a long way to go before being able to uphold the universal right to health and comprehensive health care based on individual and collective health needs. While progress has undoubtedly been made, the SUS that is currently taking shape increasingly resembles the precarious living conditions of the 70% of the Brazilian population that use it on a regular basis. In the SUS, as in deprived areas, there is neglect with the ambiance, with the efficiency of public service delivery and, most serious of all, with the people that use and work in the system. The SUS is gradually becoming yet another space dominated by the rationality of the age-old traditional promiscuity of Brazilian politics. In short, the SUS has shaped its ethics, aesthetics and operational standards in line with the way of life of the majority; in many respects and situations, confirming a pattern of disrespect for human dignity. There is deep-rooted economic, social and political inequality in Brazil. It is as if there were two worlds coexisting in the same territory. Despite significant progress in reducing poverty in recent years, two-thirds of the population earn less than two minimum salaries. There are also deep inequalities when it comes to power. The composition of the National Congress confirms the imbalances in political representation, being made up mostly of businessmen, men and whites. Machismo is the dominant culture, while in public and private organizations the terror and arbitrariness of managerialism prevails. Cities are split in two, with gaping differences in basic sanitation, transport, housing, urbanization, leisure, and public security. We only need to look at the Map of Violence to realize that there are two Brazils. Governments have concerned themselves more with economic growth and maintaining the power of the elites than social and human development strategies. "For whom is it intended", the SUS?-Caetano Veloso would ask. Is the concrete SUS really a system that "belongs to all of us and is for all of us"? Defending the SUS involves combatting inequality, promoting a shift in current economic and social policy, and imposing public interventions aimed at promoting equality and well-being. The phrase I tend to use, "We are hope... and the others", is a metaphor that expresses certainty that defending the SUS, democracy and social rights, particu...

Care handover to chronic conditions to regionalized planning

“…Moreover, empirical data indicate that the reduced work hours of health teams and the inconstant flow of referrals between the municipalities impair the creation of bonds with chronically ill users and organized and planned health actions. This context indicates the still current challenges of primary care (4) since users need to feel welcomed and cared for during the transition of care, especially those with chronic diseases (19) . Furthermore, health workers must cope with the persistent issue of not having an established referral and counter-referral system, which weakens the transition from care (19) .…”

“…The challenge in collective health care is transitioning care in a scenario that does not adapt to assist chronically ill users and has a limited capacity to promote health and prevent diseases due to factors such as the unstable establishment of public policies (1,(3)(4)(5)8) .…”

“…However, in view of the economic conjuncture of fiscal austerity, the role and intervention of the State in health care have progressively diminished. This scenario in health services provision has affected the health condition of people, especially with regard to patients with chronic diseases (3)(4)(5) .…”

Interlocuções entre a Declaração de Astana, o Direito à Saúde e a formação em Medicina de Família e Comunidade no Rio de Janeiro, Brasil

“…Inflation has been known to be lower than Net Current Revenue (NCR), a parameter previously used as a Public Health resource level. The significant consequence of Constitutional Amendment N° 95 4 will be to prevent public health investments from increasing in real terms for 20 years, harming most of the Brazilian population, the exclusive user of the SUS, and subject to use a neglected SUS in its ambiance, management and the qualification of its professionals 5 . Thus, we are witnessing a political project that aims to transform the social conditions of the subjects, through State interventions, in what Foucault 6 calls governmentality, that is, power relationships become a field of actions of multiple possibilities, but with the same nature: acting on a population, on the actions of others (government of others) and even on oneself (self-government).…”

Análise do Portfólio Reflexivo como instrumento de avaliação formativa em um Curso de Bacharelado e Licenciatura em Enfermagem

“…Sobre o fortalecimento do SUS, Campos (2018) A enfermagem enquanto profissão articulada à conformação sócio histórico brasileira detém em sua trajetória, momentos que se fortalecem em relação à própria legislação (de enfermagem), mas também em relação à legislação em saúde, fazendo com que ora atue com certa conformação, ora com outra, ou, seja, de acordo com os distintos projetos atuantes (um de cunho igualitário e outro de cunho neoliberal). Dessa maneira, a enfermagem brasileira vem enfrentando os distintos Brasis existentes, e, com isso perpassa dificuldades e percalços em sua construção como prática social, no que se entende nos modos de operar, pesquisar, cuidar e ensinar, diferentemente do que está posto hegemonicamente.…”