A dive in a recent past
José da Rocha Carvalheiro
Consultant of Saúde e Sociedade, together with Augusta Thereza de Alvarenga, he was one of the editors of the first issue (1) of Saúde e Sociedade. He is editor of Revista Brasileira de Epidemiologia (Abrasco)
The greatest difficulty for historians is to analyse their lifetime, because there is a lack of perspective. Maybe, for this one says that there is nothing more dynamic than the interpretation of the past. It is then, very courageous of Solon Magalhães to accept the challenge to revisit, after 13 years, his article about SUS and the parting of social security resources, published in Saúde e Sociedade in its first issue, in 1992.
This is an issue that deserves a special attention from readers, not because it is the first one. The Editorial brings the declaration of principles of those directly responsible for the review and of the managers of the responsible institutions: the dean of the School of Public Health of the University of Sao Paulo and the president of the Public Health Association of Sao Paulo. There is a moving homage to Cecilia Donnangelo, in an admirable text written by her main disciple, Ricardo Bruno. Two articles on epidemiological surveillance, interesting to read because the authors have been in charge of important public jobs in diseases control in the state of Sao Paulo, in crucial times.
An article by one of the editors of the review, about epidemiological issue of emerging and re-emerging diseases, follows. A discussion about social sciences in health is the theme of another paper. And finally, the article by Solon Magalhães Vianna, one of the greatest specialists of our country in the issue, that analyses "Social security: SUS and the parting of resources".
To this revisit, a comment by Eduardo Jorge is added, called "Seventy cents". This is the amount spent per person by SUS, according to the author. The author, an active leader of the sanitary movement in Brazil, was the federal legislator directly responsible for the Constitutional Amendment 29 that allocates a fixed contribution for SUS. In his comments he shows the difficulties to comply for the constitutional determination, but confirms his confidence in the consolidation of SUS. In a reply, Solon presents a picture in which SUS is in a double and opposite way. Brazil denies accepting a liberal model for health services as recommended by World Bank: to focus in positive externalities as vaccination and sanitation programs, but leaving individual care for private business; on the other hand, through SUS, the country tries to revert this process. By adopting the universality principle, effective in some developed countries, Brazil goes on another contrary way. Differently than the other countries that adopt this principle, in our country the private expenses with individual care are already larger than the public expenses.
The original text by Sólon, its revisit after 13 years, Eduardo Jorge´s comments and the reply must be a re-joy for readers of Saúde e Sociedade." Far from de-motivating, they must serve as stimulus for fighting" is the last phrase of the debate.