"Our model of health does not work"

Author (s): Hugo Marques
Ie - 28/06/2010




José Gomes

The minister acknowledged that public hospitals do not meet the needs of the population and are taken by corporations




For three years in office, Health Minister Jose Gomes points out advances in the industry, but does not feed the expectation of more imposing First World care in public hospitals in the country "Our current model of health, based on direct administration, not working to provide quality service to the people, "said the minister, in an exclusive interview with IstoE. "Many public hospitals are privatized by corporate interests." Temporão date have not assimilated what he considers one of the biggest scams in Health: the extinction of the CPMF, a tax check. "The loss of $ 40 billion of the CPMF was dramatic," he says. "Without new money, we will not solve the problem of Health" He advises the next president to plan early in the mandate of Health funding among the positive initiatives of his administration, Temporão shown pleased to have suggested the creation State Foundations of private law to manage hospitals.


This proposal was rejected by Congress, but has been incorporated by some state departments. He also celebrates the rate of vaccination against swine flu that exceeds that of European countries. "Brazilian society is protected from influenza," says. In the interview, Temporão still had fun with the repercussions of his advice to the Brazilians who have sex five times a week. "You never discussed both the hypertension."


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The Ministry of Health has always been criticized for mismanagement. The problem persists?


José Gomes - We saved the last three years $ 800 million buying better, making trading, negotiating with suppliers. In this area we moved a lot. The Ministry did not tender since 1981, it was all outsourced. We hired 15 500 people per contest.
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Often depends on the care of hospitals run by states and municipalities. And it works. How do you. see it?


José Gomes - Health in Brazil is built every day to six hands. The service actions, the management of hospitals, it is run by municipalities, mainly. I believe that our current model, based on direct administration, disk, which can work very well for the central level of a ministry to the IRS for the Federal Police, no work to provide quality service. I can not take a year and a half to hire a neurosurgeon. The people can not wait for service. So I launched the proposal for public foundations under private law.
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But the proposal has not passed by Congress.


José Gomes - It's true. But what comforts me and encourages me is that many States have made such a proposal. Rio de Janeiro, Bahia, Sergipe, Pernambuco, Distrito Federal, Espírito Santo, among others, have adopted these and other similar strategies. You have many initiatives of social organization and foundation of the state. And that certainly leads to a more professionalized, more immune to political pressures.
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Many people said that this would be the privatization of public health.


José Gomes - is a complete mistake. The problem today is that many public hospitals are privatized by corporate interests. Prevailing interests of corporations rather than public interest. This is the game. When we launched the idea of founding a state private law is a public entity. She is required to attend SUS 100% free. You work on top of targets and indicators. And there's a management contract, the organization shall be assessed all the time. Today, public hospitals still operating in the old way, the evaluation is zero.
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In Brasilia, the prosecutor suspects that the public system was scrapped to pass clients to private hospitals. There is this policy in the states?


José Gomes - Possibly, there may be. Sometimes, political interests, special interests at the tip, can lead to distortions of this type. But the Brazilian Constitution is very clear: you can only hire private services after exhausted the capacity to serve the public sector.
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Mr.. fear any retreat in Health or think that society has to push more for better health?


José Gomes - Health today goes through transitions. The first is demographic. The country is aging at a rate greater than that of countries in Europe in the early twentieth century. The second is epidemiological. With the older population, more chronic disease, more diabetes, hypertension, stroke, heart attack and cancer. The third is technology. Increasingly I am of industry pressure to incorporate new drugs, devices, laparoscopic. The fourth transition is food. With the change in the pattern of the family, where the woman works more and more, increases the consumption of food semi-prepared and ready.
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And obesity also becomes a problem?


José Gomes - How to consume more soft drinks, snacks and candy, increases obesity. Today, 40% of the population is overweight and 15% can be considered obese. We also have a cultural transition. In 20 years of SUS, there was a very large growth of knowledge of people about the importance of health, prevention. The population increasingly aware that the health service of good quality is right guaranteed in the Constitution. But without new money will not solve.
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By the way, Mr.. demanded the end of the CPMF, which reduced the annual budget from $ 40 billion.


José Gomes - The loss of $ 40 billion has been dramatic. Imagine if today the ministry had $ 40 billion more in your budget? What does that mean? Means I can reduce regional inequalities, increase the supply of certain services, pay the best professionals, feed into this network.
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Many people who pay health plan says that not receiving care at the time as you need. What can you do?


José Gomes - The NSA takes steps to change this situation and eventually determine the incorporation of 70 queries. All plans are required to provide these new services. We can not risk the same happening in the United States. There, Obama had to intervene to make a reform because the American system is the most expensive in the world, spends more and is the most inefficient.
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The three presidential candidates are concerned about the financing of Health


José Gomes - And that's a problem that must be tackled early in the next government. The Brazilian economy is growing too, we will have additional resources that can be allocated for health. There is a great discussion on additional taxes for industries that cause health hazards, cigarette, drink.
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What Mr.. recommends the Brazilian citizen to maintain health these days?


José Gomes - Cigarette, no way. Is involved in 200 diseases and causes 200 000 deaths per year in Brazil. The drink abuse can also cause serious health problems, mental, organic, cardiac and vascular EPAT.
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Mr.. also urged Brazilians to have more sex to prevent hypertension. How was the impact?


José Gomes - The reception was very good. It is a topic that many people take a joke, but I take the positive side. Never discussed either hypertension, which is a silent disease and kills many. And of course when I spoke to have sex five times a week I was not willing to do anything prescriptive. Each couple has its rhythm, but I wanted to draw attention to the importance of sex as a key component in happiness and in maintaining a healthy body and mind.
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Mr.. said Funasa is a corrupt body. We must change this picture?


José Gomes - has to change everything. With the decentralization of the health system, where the municipalities have assumed this role and it was Sucam Foundation Sesp, Funasa was without a light object. What she fulfills is insufficient to account for its size, the expense that the Brazilian people have with this foundation. It has to be redone. 500 municipalities in Brazil have no doctors, no nurses.The idea of creating a national force to address health epidemics, natural disasters, floods, landslides, composed of doctors, nurses, sanitarians, who could move to any point of Brazil, is a good alternative to Funasa.
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Funasa was not the victim of a political subdivision?


José Gomes - Was there really a major presence there of the PMDB. The work we did was technically and put the Comptroller General of the Union and TCU on top. Never had so many penalties for officials and managers as the government of President Lula.
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There is some action that Mr.. regrets not being able to deploy in their management?


José Gomes - The regulation of Amendment 29, which is independent of the minister, but the National Congress. She discusses the total expenditure on health, especially the participation of the federal government. As the amendment was not regulated, my budget is fixed annually by the change of nominal GDP.
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The cold begins now. The population can stay quiet about the flu?


José Gomes - Brazilian society is protected from the flu. We are eradicating. In relation to H1N1, vaccination this year, will make all the difference. The United States has vaccinated 23% of the population. Switzerland 17% vaccinated. Here we come to 42% of the population, far more than in European countries. We gave the show.

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