SUS

Abstract

This dissertation is a study on the organization form of the Brazilian Unified Health System -Sistema nico de Sade (SUS) that, according to article 198 of the Brazilian Federal Constitution, is a system of federative interdependence managed by autonomous entities, as set forth under article 18 of such Constitution. It adopts an interdisciplinary approach, with emphasis in the legal standpoint and interpretation of the major guidelines of the Principles embedded in the Constitution and the protection of the Basic Human right to Health. There is an initial focus on the conceptual framework of Federalism and the traditions where the Brazilian Model got its background. The Brazilian State and its organization form and structure for the Health are scrutinized: the role of the Federal State, its centralistic imposition and influence on SUS' management. The study analyses how the characteristics of federative interdependence and mutual relationship, are harmed by the strong presence of central authority, the Federal Government, through the Brazilian Health Ministry. Concerning the SUS, the federal centralism is materialized through the form of its financing, since a large amount of resources that supports it is assigned by the federal Government to programs and projects determined by federal scope, prevailing over a federal or decentralized system. That situation has a strong impact on SUS' organization, defining its priorities rather by the sources of its financing than by global health planning, that should have as its foundation the peoples need for health. The interdependence and autonomy require solutions that reaches a compromise between these contradictions, assuring to SUS a legal and administrative structure that allow overcoming its contradictions, in order to bring together an efficient system. To achieve this purpose, some ideas are presented, ideas that attempt to reconcile all required elements to a management that guarantees to citizens the right to health.