Thirty years of the Brazilian Unified Health Care System – Sustainability and challenges: strategic players perceptions

Abstract

The Unified Health System (SUS) is a step forward in reducing social inequalities. However, SUS viability and sustainability are questioned. In response, PAHO / WHO carried out a research with the objective of understanding the limits and possibilities for the consolidation of SUS, based on the technical, political and ideological positioning of the actors involved in the design and implementation process of this system. A qualitative study was developed, involving 86 actors, whose data were obtained through structured interviews and free comments.
The analyzes dealt with the right to health, integrality of care, legal frameworks, judicialization, federal relations, health care networks, social participation, models of care, primary health care profile, financing
and private public relations. The need to make changes in SUS was evidenced. However, the fear about the risks of implementing transformations in the organization of the Brazilian health system prevails in the political and economic context lived by the country in the end of the decade of 2010. The defense of health as a right, combined with the creativity and the capacity of overcoming adversity, made SUS an example for Latin America and a reference to the world, and it should continue preserving rights and defending SUS.