Healthcare sector in Brazil demands treatment

por The Winners
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Claudio Lottenberg, Chairman of the Albert Einstein Brazilian Israeli Beneficent Society Board

The healthcare of a country’s population is a historical social right acquired over the years. In the case of Brazil, it is even ensured by the 1988 Constitution.Therefore, healthcare does not depend on current administration or political guidelines by authorities. That said, it is up to us – the medical and scientific community – to seek the efficiency and effectiveness of treatments that guarantee universal access to healthcare, whether financed by the public and/or the private sector.

The healthcare system in Brazil is partly the victim of a contradictable positive trend due to the fact that over the past few years, public policies have significantly increased the life expectancy of Brazilians. According to the Brazilian Institute of Geography and Statistics (IBGE), Brazilians born this year will live on average 76.7 years, much more than the 69.8 years of those born in 2000.

And life expectancy will get increasingly longer. The expectation of those born in 2040 is to live 79.9 years. Moving further into the future, our great-grandchildren who will come into the world in 2060 are expected to live on average more than 80 years (according to the current projection, 81.2 years). Surely excellent news, but the elderly population rise increases the pressure on a healthcare system that already faces enormous challenges. It is in this age group that health care tends to be more intense, due to the greater occurrence of chronic diseases, which become more common as age advances.

Healthcare disputes its space in a public budget of social nature, and is always inferior to its various demands. Currently, Brazil spends 9.2% of its GDP (Gross Domestic Product) on healthcare. The biggest problem, however, is not the total volume of resources, but their allocation. There is an evident discrepancy between the public and private systems. The public sector, which serves 75% of patients, uses only 50% of all resources. As for the private health sector, even though it has more and better conditions, it is under its own possibilities.

Professionals working in the private medical system agree that there is no reason for satisfaction. There are errors, redundancies, fraud and excessive use of expensive exams. At a time when the country’s inflation is below the 4% annual target – partly due to the slowdown resulting from social isolation to combat the coronavirus pandemic – a double-digit medical care inflation is the picture of a harmful reality to the majority.

What to do in order to change that? In my opinion, the transformation will come with a greater use of quality tools provided by the Institute for Healthcare Improvement (IHI), a benchmark institution based in Cambridge, in the United States, which supports processes to improve health organizations in different regions of the world. IHI recommends the adoption of a governance system that sets changes in approach, structuring and monitoring of healthcare services.

Firstly, it is necessary to focus on the quality, safety and efficiency of services, in order to best meet patients´ needs. Second, there must be a reduction in the per capita cost of healthcare, by focusing on scientific knowledge to ensure the effectiveness of resource application. Third, a population approach that multiples successful individual experiences and adopts adjusted service strategies to the specificities of different groups should be taken into account.

I have also argued that the concept of healthcare should be ex-panded. Issues such as sustaina- ble cities and nutrition should be placed on the agenda of the national healthcare debate, as well as the pressing need for a digital transformation. A digital world will bring the much need-ed transparency, making redun-dancies visible and enabling structural changes that lead to process improvement.

I also defend the necessary inclusion of telemedicine as part of healthcare practice. Telemedicine stems from the advent of telephony and its advances of modern mechanisms in image transmission; today it has grown with applications and tools that help even in assisted propaedeutics.

The current policy of social distance has driven many healthcare professionals to practice telemedicine. The results have been encouraging. Minor cases can be resolved remotely. Even more serious cases are subject to initial screening, saving time and resources, both scarce and precious items.It is indeed a practical example that the introduction of necessary changes can improve the overall healthcare scenario in Brazil.

I also defend the necessary inclusion of telemedicine as part of healthcare practice. Telemedicine stems from the advent of telephony and its advances of modern mechanisms in image transmission; today it has grown with applications and tools that help even in assisted propaedeutics.

The current policy of social distance has driven many healthcare professionals to practice telemedicine. The results have been encouraging. Minor cases can be resolved remotely. Even more serious cases are subject to initial screening, saving time and resources, both scarce and precious items.It is indeed a practical example that the introduction of necessary changes can improve the overall healthcare scenario in Brazil.

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