Abstract
Access is a central concept for achieving the universality of SUS, but little valued in the official publications of the Ministry of Health. Perhaps because of this, access in the SUS is still seen as excluding. Since the implementation of the Family Health Strategy, there has been an important improvement in perceived access by users, although the middle classes remain excluded from SUS, attracted by the purchase of private health insurance plans. This phenomenon was observed in the territory of a Family Health team in the Grajaú neighborhood, Rio de Janeiro, traditionally middle class, whose residents systematically refused registration and follow up by the team. This paper aimed to analyze the narratives of refusal of these individuals, through thematic and content analysis. It was noticed a stigma associated to the use of SUS and its professionals, and greater confidence in the purchase of the health service, justified by the fear of the lack of beds for hospitalization and emergency care. In addition, the interviewees did not appropriate SUS as a right. Brazil is under serious political crisis and the SUS, which has always resisted under threat, is even more at risk. It is necessary that the population can see a functioning SUS and take ownership of it.
Keywords:
Family Health Strategy; Health Services Accesibility; Social Class; Social Behavior