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Public Healthcare in Brazil- Sistema Único de Saúde

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So all of my research on babies has of course made me more aware of the healthcare system in Brasil.  A lot of which I am told was the “inspiration” for Obamacare.

From various stats between 20-25% of Brasilians don’t use the public healthcare system, the lack of private healthcare is that rampant.  From WHO, it seems that pre-1970 the lack of healthcare was abysmal.  Which of course makes sense when you have a country as large as Brasil, with the problems of under-education, and large illegal or blue collar/self employed work force (farmers…etc).   So while the Brasilian people are taxed heavily, I can see how something like this really makes sense for this country.  The life expectancy of a Brasilian is 73.5… compared to back before they had this large scale healthcare… and it was like 45 years old. So that’s obviously a big difference. Of course economic growth and wealth I’m sure have helped increase that too.  Also, as the wealth in Brasil increases more and more individuals are supplementing their free healthcare with private healthcare too, because well the public system IS the public system.

The system is a mix of Federal and State funding.  So Sao Paulo public healthcare is great when you compare it to say Piaui (where my nanny is from), as their state isn’t as rich, so things aren’t as good.  And of course, it’s Brasil, so there is of course the usual wasteful money dealings that go on …

A recent survey of Brasilian health care published in the Lancet, an international journal, argued that SUS gets poor value for the money it spends on drugs, because too much goes on complying with court orders granted to patients who use the constitution’s lofty promises to demand expensive treatments not automatically covered by the system. And too much of the budget still goes to hospitals rather than the Family Health Programme, says Michele Gragnolati of the World Bank.

From the Economist, it seems that not everything is free with the healthcare (which it shouldn’t be), but the Brasilian population is pushing for even more coverage. Ironic, as I feel there are bigger issues that needed to be addressed before adding to the issues.

An audit carried out in 1997 by the Ministry of Health showed that at least an amount equal to US$ 557 million (R$ 600 million) belonging to the federal health budget goes missing every year. World Health Organization

Yeah corruption and waste… go figure the Brasilian system has issues with corruption.  In fact, the health system here in Brasil is so bad, that the private insurance systems (other than the cost of those hotel room suites for maternity), have been able to charge ridiculously high prices.

In São Paulo, for instance, the best hospitals charge fees that are sometimes higher than those charged by well-known hospitals in the United States. Some health insurances are even offering Brasilian patients the option of receiving health care in the United States since, in certain cases, the costs of transportation and treatment in the United States are lower than getting the same treatment in São Paulo.

To be fair as an American, I fully admit the US system has its issues.  We spend more than any other country, not everyone is covered, and we are SUPER SUPER inefficient.  Which is yet another reason we shouldn’t have jumped right into universal healthcare straightaway. BUT we are still set up better than Brasil to handle the issue, as at least we definitely have the infrastructure in place.


Politics– in Brazil

Not that I really follow Politics in Brasil, I’m having a hard enough time keeping my house running, working, raising a child, growing a child, and keeping up with this blog.  But if I did, I’d be following the US’ election (my husband is an ardent Republican, so we spend many a night up till 2am watching each and every GOP debate).  I do happen to know a few Democrats, and one of them recently posted a Gallup poll stat, intending to demonstrate that things aren’t as bad as we think.  I tend to disagree, as I’m one of the few people I know who are happy with their financial situation.. and that’s because I’m in the ever so lovely (albeit expensive) Brasil.  Lucky me!!!

The Gallup Poll stats paint a pretty dismal picture of the US.  Basically when I started College the world was all roses, and then slowly began to decline until it hit right about where we are now:

The extent to which Americans are suffering financially because of the nation’s protracted economic downturn is evident in the large numbers — 49% — saying their personal finances are worse than a year ago. With barely 3 in 10 saying their finances are better, this is among the worst evaluations Americans have given of their finances since Gallup began measuring this in 1976.

Half the US Feel Worse Off Financially- Gallup Poll

So I mentioned this to the spouse, who pointed out that when President Lula left office after like 8 years, his approval rating was 88%. This is completely unheard of in US politics.  Almost all of our Presidents are hated by half or more of the US Population, then years later we look back on them with rose colored glasses. But still that high of a rating is unheard of in the US.

Now not everyone (I hear) loves Dilma, but I ran some stats on her, and she’s at a 72% approval rating as of January.  Employment is up, trade is up, and Brasil moved from 7th to 6th in GDP.  This is a growth economy.  So again, while people have their opinions, she seems to be doing okay.

Because I can’t be TOO pro Brasil, I will point out that there is still a lot that Dilma needs to take on politically.  For instance, the insane taxes.  I can always tell the Brasilians at the airport as they’re the ones with the carryons stuffed to the brim, and two 70lb suitcases.  Prices here are crazy high.

People still work like dogs here, other than the fact that they get like a month off for their Holiday, but the rest of the year they work HARD.  Crime is also a big issue, as I’ve noticed the whole pyramid scheme of employment seems to be big here. I.e the rich get richer, and the poor well they get a little less poor.  So the rich here are ever so rich, and the poor, well I’ve visited homes without toilet seats or formal showers.. and yes that’s normal, and no they were not in a favela.  Education is sadly still and issue here, and I think if that were to improve we would see a marked improvement in the living standards, crime, and salaries.  But Brasil is a huge area to manage, there are tons of severely rural towns, that we risk destroying rain forest by helping to “move into the current century” and provide running water etc., so it’s not an easy country to manage, and the solutions are not one size fits all.

And of course, again I’m just some random expat blogger, so in the end what do I really know?

Addicted to your email?

A friend sent me a news snipit regarding  answering work emails after hours . . . something I’m very guilty of doing, as I think I’m addicted to email.  I’ve stopped sleeping with the phone near my bed so that I’m not tempted… I’m that bad.

Well, it turns out that Brasil passed a law stating that if you are answering those afterhours emails or phone calls, then you may be eligible for overtime.  Brasil people don’t sue for much.  I could trip fall and break my entire face in Pao de Acucar because of a giant oil slick, and well that’s my fault for not paying attention.  However, when it comes to HR and employment then, yes there is huge protective laws for employees… and with that huge budgets for lawsuits and taxes, lots and lots of taxes.

I can tell you that my husband gets calls at all hours, Sunday, at midnight, at 5 am.  The work calls come in constantly.  And this is after he gets home anywhere between 9pm and 1am every night.  Especially in Sao Paulo, the work ethic or desire to work crazy hours is bigger with Paulistanos than with other Brasilians.

The law states that employees who are subject to this can ask for overtime pay.  I think that means my husband will still get emails and calls, and the barrage will continue. However, it means in 10 years or what have you, he could always find a lawyer to represent him to sue for overtime pay.

I do think it’s great when companies remind employees not to send emails afterhours.  VW adopted a similar stance.  I usually tend to draft emails to go out at 8am, even if I wrote them tonight. That way my co-workers are not subjected to emails, even though I’m lame and emailing them after hours.

San Francisco comes to Brasil

Ok not really, but kind of…see plastic bags are prohibited in San Francisco.  This really shouldn’t be a surprised as San Francisco is the most liberal, green, super government regulates everything city in the US.  But today a friend mentioned that at Extra they were charged .50 for a plastic bag, as in January all plastic bags will be outlawed.   So thanks to Google I confirmed it, I totally missed the announcement in May when the law was passed.  It was also put on hold by the supreme court, but I think it will still take affect in January now.


A couple of arguments against the ban made me laugh.  One of them was that the lower income people use the plastic bags as garbage bags, and now they’ll have to buy real garbage bags.  This totally made me laugh, because that’s what we horde them for, all of the little trash cans in our house.  And in Brasil, with the whole don’t flush the toilet thing, I can see how families go through these little plastic baggies in bulk!  Yeah I have a nice big bag that I use to carry stuff in, as it’s sturdy and helps in walking home, but those little plastic baggies are so useful.  And when you have a kid in diapers, those baggies make things nicer when you’re on the go (for everyone).  I had to laugh at the argument against this, basically that the poor people should be happy that they won’t get to use the plastic baggies anymore, as then people will buy the proper plastic bags for trash, so then they won’t break and get all over the street especially when it rains, or clog the gutters (at least that’s what I got from my portuguese readings).

Per the law however it seems there still will be plastic bags for use at the feiras (street fairs), or for putting your meat (cuz seriously I don’t want my samonella mixing with my fresh fruit), or milk/dairy products.

The interesting thing is, in San Francisco they at least provided an alternative… these cornstarch based bags or paper bags. Here the only thing they’ve got are these teensy plastic bags, so they’re even one step more hardcore than San Francisco.

It will be interesting to see how the Brasilian jeito comes out, as even though buying a reusable bag once isn’t too much money, it does kind of suck when you bring one of those bags and then buy a little bit more than can fit in one, and are at the store forced to buy another one. For me not a big deal, for a Brasilian on a tight budget, I’m gonna say that’s the difference between milk for breakfast or not.  Plus why pay for something you know you could get for free… I guess we’ll see people using boxes to load things more now too, as like I said, paper bags don’t exist here.  Probably a good thing, as we all love the rain forest as it is now, not as a big soybean farm.


Check your underwear

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I had to laugh when I read this news article.

Brazilian underwear to come with health warnings after 12 years of debate

Just like the cigarette packages here that comes with warnings, your underwear will also come with warnings.  You think they’ll be as … um graphic as the cigarette packaging?

So check your underwear packaging, because if you buy it in Brazil it’s going to remind you to get those mammograms or check for prostate cancer, and if you are a woman your underwear will remind you of the importance of condoms in preventing cervical cancer (seriously the zillion other reasons why condoms should be used were not important? And why are only woman’s underwear targeted?).

What’s hilarious (or sad) is that 12 years of government money was wasted on this bill.  The Brazilian government could have been looking at sooo many other important issues, but they spent their time on this one.  I also agree with the manufacturers, it will cost more for them to implement, and those costs will be passed along to the end user.  So next time you ask why things are so expensive here in Brazil, well here’s yet another reason.