30 Plenary Vinod Vyasulu

8/3/2019 30 Plenary Vinod Vyasulu

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Presentation prepared for an International Conference organised by the Centre for Public

Policy, Indian Institute of Management, Bangalore, December 30, 2011. This research was

sponsored by the Centre for Budget and Policy Studies, Bangalore. I am grateful to Brazilian

scholars and government officials who gave me generously of their time. I visited health

institutions in Brasilia, Manaus, Belo Horizonte and met with professors in Rio de Janeiro,

Recife and Sao Paulo in addition to the other cities. This is an overview study of thesystem, not a evaluation of what Brazil has achieved. Responsibility for errors of fact and

opinion is mine alone.


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See also:

http://portal.saude.gov.br/portal/arquivos/pdf/financing_health_policies_in_brazil.pdf.

http://www.lachsr.org/documents/healthsystemprofileofbrazil-EN.pdf of 2005, is a useful

reference.


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The Gini Ratio has reduced from 5.8 to 5.2...swtill very high. In India it is 3.8.


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See also http://worldfocus.org/blog/2009/01/26/the-highs-and-lows-of-universal-health-

care-in-brazil/3768/. This is from a US perspective, and sees a competition for resources

between primary care and tertiary care. I see it as underfunding of health as a whole.


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See also http://siteresources.worldbank.org/SOCIALPROTECTION/Resources/0527.pdf.

http://www.ipc-

undp.org/doc_africa_brazil/Webpage/missao/Artigos/CadastroUnicoJoanaMostafa.pdf.

The central idea is to collect and keep updated, through decentralized data entry, a

concise number of variables with clear and standardized response options. Therelatively easy-to-use format of the questionnaire as well as the proximity to the

data generating fact ensures more precision and enables faster updating processes.

Alongside, the decentralization as well as the standardization of the responses

guarantees, on the one hand, national coverage, on the other, utility for national

policy makers usage.


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UPA: Units of Prompt Assistance. There are complaints of loing waiting times at UPAs. This

could be due to underfunding of the health as a whole.

See also http://www.scielo.br/pdf/rsp/v45n3/en_2335.pdf.


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Often also teaching hospitals attached to universities.


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Launched after careful preparation.


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Guarana is grown in the region and has many uses. It is like our traditional cereal like ragi,

slow in digesting. A processed version is available as a soft drink in other parts of the

country. I saw some packets being sold as a Amazon viagra.


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I have heard that members of the Commission are retred executives of the insurance

companies, and some argue they have been captured. They have introduced some

reformsshift from one company to another, some uniformity in the plans and rates etc.

They have also regularly approved increases in premia.


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We need to understand this complaint about waiting. It is trotted out as a problem

whenever we discuss public provision of a service. In Bangalore, we have to wait at private

hospitals, sometimes for two hours, after paying the full fee. If we ask for service to be on

arrival, then the level of investment will be very high. For non emergency matters, good

organisation together with moderate wait should be acceptable.


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As I see it...


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My views...


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30 Plenary Vinod Vyasulu

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