Mendes Áquilas, Melo Mariana Alves, Carnut Leonardo
Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brasil.
Pontifícia Universidade Católica, São Paulo, Brasil.
Cad Saude Publica. 2022 Feb 11;38(2):e00164621. doi: 10.1590/0102-311X00164621. eCollection 2022.
This is a critical essay on policies for primary healthcare (PHC) adopted by the Jair Bolsonaro government in the Brazilian Unified National Health System (SUS), particularly in the first year of implementation of its new model for allocation of budget funds. The first part addresses the measures and effects of the first year, revealing the on-going process of valorization of an "operational SUS" as opposed to the principle of universality. The second part analyzes some evolving scenarios in the implementation of the new model for "financing" PHC in terms of losses and gains in funding, especially in two state capitals, São Paulo and Manaus, bearing a direct relationship to the problematic situation a year since the novel coronavirus pandemic struck. This exercise aims to relate the values in the Weighted Capitation Component for these municipalities, comparing the year 2019 (without the new model) to 2020 (one year after implementing the new model). The destruction of universality in the SUS via PHC continues in full sway, as the data show. If the situations in Manaus and São Paulo (with financial losses when compared to the funds received in 2019) in fact represent a trend, it is likely that the underfinancing produced by the new PHC allocation model will happen in other Brazilian cities in an unequal and combined pattern according to their realities.
这是一篇关于雅伊尔·博索纳罗政府在巴西统一国家卫生系统（SUS）中采取的初级卫生保健（PHC）政策的批判性文章，特别是在其新的预算资金分配模式实施的第一年。第一部分阐述了第一年的措施和效果，揭示了与普遍性原则相对的“运营中的SUS”的持续增值过程。第二部分从资金的损失和收益方面分析了在圣保罗和玛瑙斯这两个州首府实施初级卫生保健“融资”新模式的一些演变情况，这与自新冠疫情爆发一年以来的问题状况直接相关。这项工作旨在关联这些城市加权人头费组成部分中的数值，将2019年（未采用新模式）与2020年（实施新模式一年后）进行比较。如数据所示，通过初级卫生保健对SUS普遍性的破坏仍在全面进行。如果玛瑙斯和圣保罗的情况（与2019年收到的资金相比出现资金损失）实际上代表了一种趋势，那么新的初级卫生保健分配模式导致的资金不足可能会根据巴西其他城市的实际情况以不平等且综合的方式出现。
