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FP: Brazil's Public Option

Author: Eduardo J. Gomez
September 2, 2009

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Eduardo Gomez writes that as President Obama pushes to pass healthcare reform in the United States, "he would do well to examine the praiseworthy successes -- and the worrying failures -- of a decades-old universal system in the region's second-largest democracy."

Brazil's place as one of the "BRIC" emerging powers has never been in question since the term came into use in 2001. Under the leadership of President Luiz Inácio Lula da Silva, the country has emerged as a diplomatic power and the region's clear economic leader. It also happens to be one of the few countries in the Western Hemisphere with universal health care. As U.S. President Barack Obama strives to pass health-care reform in the coming weeks, he would do well to examine the praiseworthy successes -- and the worrying failures -- of a decades-old universal system in the region's second-largest democracy, one that has brought real improvements in access for the poor, tempered by financial shortfalls, declining infrastructure, government inefficiency, and new, unanticipated forms of health-care inequality. Brazil's case illustrates that if you go public, you'd better be committed to maintaining your creation.

Brazil passed its reforms more than 20 years ago during an economic phase surprisingly similar to the United States' today: fiscal deficits, recession, inequality in access to health care, and loud demands for change. If recent town-hall bickerings across the United States look bad, look back at the unrest surrounding Brazil's implementation of universal health care in the early 1980s. Massive civic protests demanded an end to health-care inequality -- an ambition that dovetailed nicely with the broader democratization movement.

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