Family and Community Medicine in supplementary health in Brazil: implications for the Unified Health System and for doctors

Abstract

This article aims to problematize the interaction between Family and Community Medicine and supplementary health in the current scenario in Brazil. To do so, it starts from a historical contextualization until arriving at the examination of some central aspects of this movement. In the history of health policies in Brazil, before and after the creation of the Unified Health System (SUS), one of the biggest challenges has been public-private relations. In this process, a field of interests, actors and disputes emerged, which weaken the possibilities of materializing health as a right of citizenship and the SUS as a State social policy. At the same time that arguments indicate that the provision of the private sector in health was a condition for the approval of the health chapter in the 1988 Federal Constitution, different forms of incentives have been granted by the State to the private sector, while, in the SUS, there is significant underfunding. Added to this is a symbolic and imaginary construction in Brazilian society, positively valuing the private health sector to the detriment of the public one.