OECD Reviews of Health Systems: Brazil 2021
OECD
Abstract
Over the past 30 years, Brazil has pursued policies to achieve universal health coverage.The Constitutional Reform of 1988 gave rise to the current Unified Health System (Sistema Único de Saúde, or SUS) and since the inception of SUS, virtually the entire population is formally covered by the public health sector, with equal benefits and equal financial protection.As a result, Brazil has significantly improved most general population health indicators, increased access to health care and reduced health inequalities.Life expectancy at birth increased by 5.7 years, from 70.2 years in 2000 to 75.9 years in 2019.Infant mortality rate has decreased by 60%, from 30.3 deaths per 1 000 live births in 2000 to 12.4 deaths per 1 000 live births in 2019.The same is true for maternal mortality rate which has decreased by 13 percentage points over the same period.However, mobilising sufficient financing for the universal health coverage mandate of SUS has been a constant challenge, not helped by persistent inefficiencies in the use of resources in the Brazilian health system.While Brazil spends a lot on health (9.6% of GDP in 2019 -higher that the OECD average of 8.8%), 60% of this expenditure is private, leaving the Unified Health System underfinanced.Furthermore, OECD projections indicate that health spending is expected to increase to 12.5% of GDP by 2040, based on demographic and technological trends, rising incomes and productivity in the health sector.