On the same day that a fire at the scrapped Federal Hospital of Bonsucesso, in Rio de Janeiro, kills three people and hastily removes more than 160 patients, the President of the Republic and the Minister of Economy published a decree that opens the door to privatization of the Unified Health System.
The two facts are not a mere coincidence, but are part of a logic that makes public health precarious and then sells precariousness as a justification for the privatization of its functions.
Precariousness is not an inexorable consequence of the public character of the system, but of a country project. A project that dreams of a system like the one that operates in the United States, based on private health plans. Who doesn’t have health insurance? Suffer and die, why.
The causes of the fire are not yet known, but the Federal Public Defender’s Office says that the public authorities knew about the risk, with transformers that operated at the limit of capacity, hydrants that did not operate and a precarious electrical system. And the Fire Department had already notified the unit more than once.
But who has the courage to close the city’s most important federal hospital in the middle of a pandemic?
It is not surprising, in this context, that the Bolsonaro administration has reduced the already insufficient budget of Hospital de Bonsucesso by 11%, compared to the last year of the Michel Temer government, according to a story by Igor Mello, from UOL. On the contrary, it makes a lot of sense.
A report by Natália Cancian, from Folha de S.Paulo, shows that a decree published this Tuesday (27th) by Jair Bolsonaro (without a party) and Paulo Guedes placed basic health units in the sights of a government concession and privatization program. The text states that studies should be carried out aiming at “partnerships with the private sector for the construction, modernization and operation of basic health units”.
Nothing is more logical than, in the face of a scorched earth scenario, ensuring that companies take over management. Precarious and sells.
The public spending ceiling rule, approved by the National Congress in 2016, and warmly defended as a civilizing measure by the political elite and the market, is part of this project of precarious public health.
The increase in the allocation of public resources for health has occurred above inflation in recent decades – in part to respond to the social demands present in the 1988 Constitution and, consequently, to try to reduce the country’s immense social gap. If the readjustment had been due only to inflation, we would have an annual readjustment and the size of the service offer would not even follow the population growth, leaving everything as it was. That is, in the mud.
If the quality of the public service was still insufficient to guarantee the dignity of the population, it is because the deficit of dignity is huge here. We are not in Sweden or Norway, which is just to maintain the standard, we have to run after the loss.
Now, with the spending ceiling tied, new investments in hospitals can only occur if, on the other hand, precarious health posts or flatten the salaries of doctors, nurses and technicians or even take money from education or public security.
Yes, the main problem of the Unified Health System, more than management issues, is underfunding. That is, lack of chronic money.
Also part of this project of precariousness and privatization of the system, are the recent statements by the government leader in the Chamber of Deputies, Ricardo Barros (PP-PR). He complained that the Brazilian Constitution “only has rights” and that it needs to bring more duties to the population. And that made the country “ungovernable” because of the need to enforce those rights. He wants to throw the current Constitution in the trash and make a new one.
Barros is consistent, at least. I had already said that, in May 2016, when he was Minister of Health for Michel Temer. That month, he defended a reduction in the size of SUS: “The more people can have plans [de saúde], better because they will have a service sponsored by themselves, which alleviates the government’s cost of sustaining this issue “. It is worth remembering that in 2014, the minister received R $ 100 thousand of electoral donation from a representative of the health plans sector .
There is a lack of resources for the Emergency Medical Assistance Service (Samu), the Family Health Program, the vaccination system and the refit of hospitals. In other words, remove sick and injured people, prevent diseases in the poorest, avoid epidemics and suffering and unnecessary deaths and basic equipment to serve the population.
Revise the spending ceiling, increase the progressivity of taxes on income and wealth by biting the super-rich, guarantee resources so that the Unified Health System can operate as it should, bury the coup intentions of a new Constitution just to silence the mass it charges let the dead letter come off the paper.
For those who claim that corruption is inherent to the public nature of the institution, it is worth remembering that the removal of the governor of Rio, Wilson Witzel (PSC), due to a scheme of diversion of public resources that would go to fight the pandemic involved an organization Social.
Meanwhile, the federal government continues with tens of billions of reais in tax exemptions and subsidized credit for the business sector, which flows into the pockets of its shareholders, and owes the Unified Health System.
No one denies that the public deficit needs to be addressed and that bitter solutions must be proposed and discussed. And everyone will have to contribute, poor and rich. But Brasil de Temer and Bolsonaro guaranteed a remedy that, to cure the economy, kills the poor.
Makes sense. It seems that there will be no room for the poor in this brave new Brazil that can emerge from this country project.