The paper discusses the paradoxes of some unanticipated consequences of the actions in the field of collective health, created by the universal egalitarian ideal formulated by the Brazilian Constitution, and also the dilemmas that nowadays are posed to the public health system.
An analysis based on the present hypotheses on the relationship between the public and private health care systems was carried out using an empirical investigation, with special attention for the local knowledge.
The sampling technique used was the "experts sampling method". This method identify the most important actors involved in the process of institutional implantation and management in the realm of the Brazilian Unified Health System (SUS).
Forty-nine participants were interviewed, all of them key actors in both public and private health institutions. Finally, a comprehensive survey of available documents and statistical analyses were undertaken.
The results highlight a perverse interaction of the Unified Health System with the market, as a consequence of the unorganized implementation of the Sanitary Reform, determining serious barriers toward the implementation of a reliable and equitable financial structure of Brazilian Health System. The public social insurance taxes are compulsory in Brazil, but the common citizen pays also private health insurance plans, but remain unsure about the perspectives of receiving satisfactory treatment.
So, in the Brazilian health sector, a game of "rescue yourself, if you can" is going on, in which neither the public system or the market address in fact the complex problems in the domain of medical care.
Health policy in Brazil; The Brazilian Unified Health System and the Market; Public and private health
