The title of the 2015 Editor’s Comments could very well be from a journal published in decades past, a time when, in Brazil, all professional entities and civil society fought for the right to health, as was later established in the Brazilian Constitution of 1988. Twenty-five years later, despite its financial limitations and restricted operational capacity to solve the population’s health problems, the distribution and interconnectedness of the Unified Health System (SUS) throughout the country has broadened access to basic health services, significantly transforming people’s quality of life in most of the country. In contrast to such advances, we are appalled by attacks on the SUS advocating that it be dismantled!

The Brazilian Association of Nursing is a civil entity that gathers nurses from all over the country. Well before the 8^th Brazilian National Health Conference, it was already fighting for the right to health for all. Since then, the association has contributed to the improvement of health care by promoting debates about the training of nursing and health professionals who are committed to the proposal of universal health care and who have the competence to share care with their peers, with equal participation of the population.

Throughout the existence of this healthcare model, nursing professionals have effectively participated to consolidate and strengthen it. Therefore, the Brazilian Journal of Nursing cannot help but express its opinion about the collapse that has been happening within the SUS.

Health has become an increasingly higher priority for people all over the world. In the same way, universal access to and coverage of health services is also a priority, in order to transform a population’s health conditions. However, Brazilians are dissatisfied with the available health services, and for many years, health has been the main problem or complaint reported by the population.

The demographic and epidemiological transition taking place in Brazil has raised the issue of how to address the care of patients with chronic diseases and the increasing frailty of ageing individuals. However, there is still a significant presence of infectious and parasitic diseases, in addition to a high incidence of noncommunicable diseases. Further still, we have experienced a significant growth in violence and death due to external causes and drug use.

The condition of the Brazilian health system points to great intersectoral challenges and macro health problems within the scope of the Brazilian reality. These must be faced in conjunction and given equal weight, since a more general solution for health depends on and involves the understanding of such relationships. Nursing plays a relevant role in facing up to the great challenges related to the provision of comprehensive, safe, and quality health care to all. Nurses represent the most preponderant professional group in the daily care of millions of Brazilians who depend solely on the SUS, from the reception of patients in all the units of the service network to more complex treatments, weaving the threads of care by assisting, managing, and guiding.

However, nursing practice depends on a consistent health system that allows for both the technical-scientific and humanistic development of the field, based on the logic of continuity of care. Most of these professionals participate in most prevention and health-promotion processes and are responsible for 60% to 80% of all basic health actions and approximately 90% of health actions in general. Thus, we cannot help but be outraged when subterfuges are created in order to privatize health, which will affect the young SUS in a predatory manner and will not ensure the population access to health.

The bill for Constitutional Amendment 451/2014, which addresses the contracting of health insurance plans by companies, considerably broadens the privatization of the sector, which has already been growing at a fast rate. In other words, it favors the private sector at the expense of greater investments in the SUS – the major health plan for Brazilians. It is urgent that we strengthen and perfect the SUS, while also discussing financing and the federal pact that maintains it.

Another misguided measure was the reiteration and constitutionalization of sub-financing through Constitutional Amendment 86, of March 17, 2015. This amendment stipulated a mandatory budget and established a percentage of government resources for health. In this case, 15% of the current net revenue (in five years) must be dedicated to health, instead of the 10% of the current gross revenue proposed by the bill created by the popular initiative Saúde + 10 (Health + 10). The approval of this mandatory budget would drastically decrease the possibility of achieving one of the most important advancements of the Brazilian Federal Constitution of 1988 – the right to health for all. If foreign capital were allowed to enter into the health sector, international companies could establish or operate hospitals (including philanthropic ones) and clinics, and carry out health actions and services.

Entities that defend the SUS have produced a document stating that such blows would cause a rupture in the right to health and promote definitive segmentation of our health system:

The Brazilian Association of Nursing calls on its associates, nursing technicians, nursing students, and specialization schools and societies to debate among peers and with the population in general about the severity of the issue here presented. We also summon all these actors to take part in preparatory activities for the 15^th Brazilian National Health Conference, along with the 76^th Brazilian Week of Nursing 2015, which may be one of the privileged forums for this debate and whose theme was specifically conceived of order to mobilize “Nursing in defense of the SUS: Constructing the 15^th Brazilian National Health Conference".

REFERÊNCIA

Publication Dates