Defender a Saúde Pública é uma tarefa urgente

Existe dinheiro para prover um sistema público de saúde com hospitais e médicos suficientes para atender toda a população com a mesma qualidade dos melhores hospitais privados de hoje

Reportagem publicada em 10 de janeiro de 2019

Hoje quem administra o Hospital de Base é a Famesp , uma Organização Social de Saúde (OSS) que também comanda o Hospital Estadual, Ambulatório Médico de Especialidades (AME) e Maternidade Santa Isabel (Foto: Lucas Mendes/JORNAL DOIS)

Por Roque Ferreira, colunista do JORNAL DOIS

A Federalização e a criação de uma carreira de Estado no SUS, com dedicação exclusiva, é a saída para termos saúde pública, gratuita e para todos, em todos os níveis. A classe trabalhadora e suas organizações devem colocar como suas lutas prioritárias o estabelecimento de um Sistema Universal de Saúde Pública federal, gratuito, de qualidade para todos os cidadãos brasileiros.

Apesar de já existir o SUS (Sistema Único de Saúde) — que foi uma conquista para propiciar o atendimento médico gratuito para qualquer brasileiro — é desumano que aqueles que têm dinheiro possam ser atendidos nos melhores hospitais privados do Brasil enquanto milhões de brasileiros pobres têm que se sujeitar às filas nas Unidades Básicas de Saúde. Em muitos casos, sequer estas unidades existem em muitos municípios, aldeias indígenas e terras quilombolas. As Unidades de Urgência e Emergência de prontos-socorros públicos são outra grande tragédia, onde, com poucos médicos, muitos pacientes são atendidos nos corredores ou morrem nas filas sem sequer serem atendidos, como o que ocorreu em Bauru, uma das maiores cidades do estado de São Paulo, que contabilizou 581 pessoas que esperavam vaga para internação e que morreram em corredores do hospital, o que está sendo objeto de investigação determinada pelo Ministério Público.

Este cenário não muda. Enquanto fica um grande jogo de empurra entre União, estados e municípios, a população trabalhadora continua a morrer nas filas das Unidades de Urgência e Emergência. De janeiro de 2017 a maio de 2018, 117 pessoas morreram aguardando leito para internação na cidade de Bauru. Este cenário se repete em todo o estado de São Paulo e no Brasil.

Esta situação tende a piorar, considerando que não existe nenhum trabalho articulado que tenha como prioridade o atendimento primário à atenção básica nas Unidades de Saúde da Família e nas Unidades Básicas de Saúde, locais de cuidar de fato da saúde e não da doença, o que é feito nas unidades hospitalares, quando se consegue uma vaga.

O Programa Mais Médicos vinha suprindo uma necessidade primária de falta de médicos para atenderem em Unidades Básicas de Saúde, e em locais onde a maioria dos médicos formados no Brasil não manifestam interesse em trabalhar. É uma solução provisória e a ruptura do contrato com Cuba mostra os seus limites e a sua ineficiência.

Com a ruptura do contrato de Cuba com o Brasil, que matinha médicos cubanos no Programa Mais Médicos, o Conselho Nacional de Secretários Municipais de Saúde (Conasems) aponta que pelo menos 285 cidades em 19 estados do Brasil devem ficar sem médicos dedicados à atenção básica em saúde na rede pública. Nas UBSs é que se realiza a prevenção, diagnóstico, tratamento, reabilitação, redução de danos e manutenção da saúde.

Já as Equipes de Saúde da Família, que além do médico contam com outros profissionais e que são responsáveis por até 4 mil habitantes, também atuando na prevenção, diagnóstico, tratamento, reabilitação, redução de danos e manutenção da saúde, poderão vir a ser desmontadas em todos país.

É fato que o Programa Mais Médicos não era a fonte dos milagres, pois atuava dentro de um sistema que não privilegia a saúde pública. Como a maioria dos municípios são responsáveis pala Atenção Básica (Postos de Saúde, Unidades de Saúde da Família, Unidades de Urgência e Emergência, Unidades de Saúde Mental), os prefeitos ficam sob uma brutal pressão, pois não recebem recursos suficientes para dar conta da demanda nem do Governo Federal e tampouco dos estados, sempre sob a alegação de que não existe dinheiro.

Existe dinheiro para prover um sistema público de saúde com hospitais e médicos suficientes para atender toda a população com a mesma qualidade dos melhores hospitais privados de hoje, mas para isso é necessário que o Governo Federal e o Congresso Nacional destinem o dinheiro público para a saúde e não para os banqueiros que nos saqueiam com o pretexto da dívida pública.

Todos os anos, quase metade do orçamento da União é destinado para pagar essa dívida que não foi o povo que fez — e que já foi paga há muito tempo. Enquanto isso, a saúde pública recebe cerca de 4% do orçamento. Isso tem que mudar!

Além disso, mecanismos como a DRU (Desvinculação de Receitas da União — que retira anualmente 20% de recursos da saúde para o pagamento da dívida pública) e a LRF (Lei de Responsabilidade Fiscal — que condiciona o orçamento de estados e municípios ao pagamento da dívida com a União) diminuem ainda mais os recursos para a Saúde. A situação se agravou ainda mais com a EC (Emenda Constitucional) 95, que congela os gastos públicos por 20 anos, um dos ataques mais nefastos de Temer e sua quadrilha no Congresso à classe trabalhadora.

Tudo isso serve ao capital financeiro internacional que, além de investir cada vez mais em títulos da dívida pública brasileira, ainda lucra com os planos de saúde privados. Com a crise econômica, o desemprego e a pobreza, a procura de serviços públicos de saúde aumentou muito, assim como aumentaram muito os níveis de precarização.

Como se isso não bastasse, em 1998 — apenas dez anos após a criação do SUS — FHC iniciou a privatização do sistema público de saúde ao criar uma lei que permite que instituições privadas conhecidas como OSs (Organizações Sociais) administrem hospitais públicos.

Hoje, no estado de São Paulo, por exemplo, quase todos os 40 hospitais públicos são administrados pelas OSs. Essas organizações privadas contratam todo tipo de serviços sem controle público, o que inevitavelmente leva à corrupção e a saúde torna-se mercadoria, como tudo sob as relações capitalistas.

É necessário estancar o desvio de dinheiro do povo para o pagamento da dívida pública e colocá-lo a serviço da saúde, da educação e de outras necessidades básicas do povo brasileiro.


As colunas são um espaço de opinião. As posições e argumentos expressas neste espaço não necessariamente refletem o ponto de vista do JORNAL DOIS.

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