Compared to the United States, what is shocking about Brazil's presidential contest is the overwhelming consensus between the presidential candidates and the population about the Government's role as a principal provider of health care and medicines. Both current presidential candidates in the October 9th run-off, center-leftist Inácio Lula Da Silva [
http://pt.wikipedia.org/... ] and more market-oriented Geraldo Alckmin, Governor of the State of São Paulo [
http://pt.wikipedia.org/... ], publicly agree that government provision of national health care is essential.
For example, through the "Popular Farmacies" [
http://translate.google.com/... ] Brazil provides free and low-cost pharmaceuticals to the population regardless of their income and immigration status.
Lula said recently,
You can be certain that I am going to be an advocate for [national health care] internationally, asking governments that they not permit that the poor countries see their children dying because they they are denied access to expensive medicines produced by the wealthy nations' pharmaceutical laboratories. This is not an economic problem; It is an eminently political problem and, as such, it is in our hands." [ http://www.nerdhost.com.br/... ] [Tranlsated from Portuguese by the diarist.]
The Brazilian Government provides free care at clinics and hospitals and operates a national chain of Government pharmacies that typically provide medicines at 25% of the price we pay in the United States for the same products. As the Popular Pharmacy's website explains,
The Popular Pharmacy of Brazil is a program of the Federal Government to amplify the population's access to medicines that are considered essential. The Oswaldo Cruz Foundation (Fiocruz), na organ of the Ministry of health and administrator of the program, acquires medicines from public pharmaceutical laboratories and private ones, to the extent necessary, and offers them in the Popular Pharmacies at low-cost. One of the objectives of the program is to benefit principally those people who have difficulty achieving treatment because of the cost of medicines. [Translated from Portuguese by the diarist.] [ http://portal.saude.gov.br/... ]
The challenger, Gerardo Alckemin agrees with the Government's national health care policy, but says he can do it even better. A newspaper quoted the challenger as saying recently that,
Addressing health care is also means coordinating treatment and making sure that hospitals have doctors available. This isn't just talk, it's a promise," said Alckmin. The candidates program again spoke of the "Right Dose" program for distribution of medicines, based on the production of medicines in government factories and free distribution to people in need.
We're going to double the annual production of medicines and open dozens of pharmacies to distribute these medicines. We did this is São Paulo and now we're going to take free medicines to whomever needs them, with the construction of factories and incentives for the production of generic drugs, Alckemin said. [ http://www.estadao.com.br/... ] [Translated from Portuguese by the diarist.]
Brazil offers free medical care at Government hospitals and clinics with no insurers involved as greedy intermediaries. The Government directly provides free care, and those who can't afford private hospitals and clinics rely upon this care. Lula argues that his government has improved the provision of free care nationwide. Alckmin argues that his expansion of free care as Governor of the state of São Paulo is proof that Alckemin will expand and improve free care even more than Lula has. So, both of the finalists agree that national health care and provision of medicines is essential. The only argument between these candidates' public positions is how to expand and improve the provision of free medicines and medical care in Brazil.
Brazilian voters know both that they need medical care and that their Government is responsible for making it available to them. The candidates know that they cannot be elected or re-elected without convincing voters that national health care is a top priority that it will continually be improved. The only argument, ostensibly, is over whose commitment and accomplishment will be greater pursuing a goal that everyone agrees is essential.
I only wish that we in the United States, in the summit of the first world, could be as advanced in our thinking as those in Brazil and elsewhere, who have so much less resources and yet so much more good sense about a government's responsibility for the health of its citizens.
Authors Note: I support Lula and believe relatively more in his commitment to Brazil's poor and working classes, but this diary is not about Lula or Alckemin. This diary is about Brazil's national consensus that the provision of national health care is an essential part of the job of Government, as is manifest in both candidates' public commitments to this policy in the electoral campaign.