Universal health systems and the future of the Brazilian Unified Health System (SUS)

Abstract

In order to discuss the current situation, limits and possibilities of the Unified Health System (SUS) in the coming years, taking into account changes in universal health systems, this essay presents a brief review of the literature on health systems and sectoral reforms. . It records market-oriented trends, discussing certain differences between universal health systems and the political-ideological proposal of universal health coverage. It highlights several obstacles in the historical development of SUS, especially chronic underfunding and lack of government priorities. It comments on the threats to the consolidation and the risk of dismantling the SUS in the face of ultraliberal economic policies and proposals that defend market-oriented health systems. He concludes by reiterating that the biggest challenge of the SUS remains political, underlining the relevance of the struggles in defense of democracy and the civilizing achievements that are part of the Brazilian Health Reform project.