Haines A
University College London Medical School, Whittington Hospital.
BMJ. 1993 Feb 20;306(6876):503-6. doi: 10.1136/bmj.306.6876.503.
Brazil has great geopolitical importance because of its size, environmental resources, and potential economic power. The organisation of its health care system reflects the schisms within Brazilian society. High technology private care is available to the rich and inadequate public care to the poor. Limited financial resources have been overconcentrated on health care in the hospital sector and health professionals are generally inappropriately trained to meet the needs of the community. However, recent changes in the organisation of health care are taking power away from federal government to state and local authorities. This should help the process of reform, but many vested interests remain to be overcome. A link programme between Britain and Brazil focusing on primary care has resulted in exchange of ideas and staff between the two countries. If primary care in Brazil can be improved it could help to narrow the health divide between rich and poor.
巴西因其幅员辽阔、环境资源丰富以及潜在的经济实力而具有重大的地缘政治意义。其医疗保健系统的组织反映了巴西社会内部的分裂。富人能够享受高科技的私人医疗服务，而穷人只能获得不足的公共医疗服务。有限的财政资源过度集中在医院部门的医疗保健上，而且卫生专业人员通常未得到适当培训，无法满足社区的需求。然而，最近医疗保健组织方面的变革正将权力从联邦政府转移到州和地方当局手中。这应有助于改革进程，但仍有许多既得利益需要克服。英国和巴西之间一项侧重于初级保健的联系计划促成了两国之间的思想交流和人员往来。如果巴西的初级保健能够得到改善，这将有助于缩小贫富之间的健康差距。
