Lessons from Brazil: on the difficulties of building a universal health care system

摘要

A number of developing countries that are often referred to as emerging economies have turned their attention to addressing their public health issues in more comprehensive and systematic ways. One of the most notable recent additions to the ranks of these countries is India, where consultations about building a universal health care system have been going on since 2015. While the trajectory of this particular initiative and similar ones elsewhere is yet to be determined, the aim of this piece is to draw some lessons from an emerging economy that, for contingent historical and political reasons, started building a universal public health care system earlier: Brazil. The key argument offered from the Brazilian experience is that building a robust public health care system based on the principles of universality and equity is a challenge of a political economy nature and one that ought to be met at multiple levels simultaneously.