UHS development and hospital services rationing.
We analyze Brazilian health system in comparative perspective. Middle income beneficiaries migration to pre-paid private insurance makes Brazilian case similar to United States. Public hospital services delivery shows an important retrenchment enhanced by demographic growth and new expectations due to constitutional definitions. Retrenchment is selective and concentrates on obstetric and clinic services and private for-profit services. To ensure equal access it is necessary to improve public spending; diminish out-of-pocket spending; develop organizational reforms; improve government capacity.
Ribeiro
José Mendes
JM
Departamento de Ciências Sociais, Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil. ribeiro@ensp.fiocruz.br
D001938:Brazil; D003695:Delivery of Health Care / Q000458:organization & administration; D015276:Health Care Rationing; D006761:Hospitals; D007348:Insurance, Health