Daily Archives: 4 September 2011

No country’s health system is perfect. Agreed. NHS bashers and lovers, put down your weapons.

Balancing the needs of the general public adequately without overburdening the country’s coffers is something every country has to face and some manage it, whereas others don’t.

Except for Brazil – which somehow is stuck between the two. No, wait… I’m not sure.

In Brazil, like in a lot of countries, you pay for a free-at-the-point-of-use national health service (Sistema Único de Saúde, SUS). You go to a public hospital or clinic, you’re triaged, and you wait your turn.

The problem, as I found when I needed to take someone to the hospital for a minor ailment, is that that wait can be five hours before the ominous-sounding avaliação – and that only then would we be seen by a doctor. But we gave up and went home. It wasn’t worth wasting an eternity over a sore throat, even if it was a bad one that desperately needed some antibiotics. So that was Plan A out the window.

And it wasn’t just the idea of being in a hospital for five hours, it was that the hospital looked more like an overcrowded refugee camp in Rwanda. People with gaunt, sullen faces were moping around, clearly in pain – others were simply sat on their chair, head down, contemplating life and resigned to the fact that they weren’t going to be seen any time soon. And they had a chair…

Those without one had begun pacing up and down or slouching up against the walls, others had started greeting newcomers with the news that they’d just stood at the end of an awfully long queue.

Rightly or wrongly, we only stuck it out for 45 minutes and then called it a day. Bus home. Early night. The next day, after a lot of umming and erring, we went for Plan B: the private hospital.

Most Brazilians who are earning enough pay out for private medical cover – it’s very common and the private hospitals are like palaces or 5-star hotels, as I’ve now witnessed.

The 5* hotel-esque IPO Hospital, Curitiba

Not at just any hospital either. Felipe’s sore throat was seen to by a consultant otorhinolaryngologist (look it up). He was given a laryngoscopy, offered catalytic injections for the antibiotics – and, if I’m not mistaken, a full body massage. Ok, maybe not the last one.

A trifle O.T.T. for a sore throat I felt, but given the fountains, the marble surroundings and the plush leather seating – I was just thankful I wasn’t breathing in the germs of another 150 people in that public hospital waiting room who were ranging from barely sniffly to verging on death.

Just one question now, doc: how much is this all going to cost?

Let’s just say that you wouldn’t have much change from $150 once you bought the antibiotics afterwards, but we were in an out in no time.

I came out of the experience feeling, well, terrible. Terrible that if you’re not earning very much – or perhaps not earning at all… a single mother, disabled person or a pensioner… you would be left with no option but to “put up and shut up”.

“At least they have that,” someone very proud of the system told me.

But if you do have the cash, well then, come on down!

I know that a good number of countries have this dilemma – the “no middle ground”.

But here, whether you’re treated like a mighty prince or like a mangy pauper depends on your ability to fork out for health insurance. All or nothing.

I’ve now lost count of the number of times I’ve heard people saying that “private hospitals in Brazil are among the best in the world, public hospitals are among the worst”. This seems more or less accurate.

And consider this last case. Say you break your nose and it sets wonky and you want it straightened. That’s exactly what happened to one of my friends here.

So he went to a surgeon and said, Hello, he’s my medical insurance – straighten my nose, please. The doctor practically laughed him out of the surgery.

For the money I’ll get from that insurer? On your bike. You’ll need to “top that up” yourself.

So many people have health insurance that the insurers stop paying decent money to the hospitals – and the doctors find the cash another way. And that’s  hardly surprising.

For those of you in the UK, you probably heard the rumblings about the cost of the Olympics – £9+ billion – and our health system isn’t perfect – although I’m personally very pro-NHS.

Now consider this terrible situation with public hospitals in Brazil – bearing in mind that Curitiba, where I currently am, is a prosperous city.

Then consider that this country has to fund the Olympics in 2016 and the World Cup two years earlier, and that the country is virtually starting both from scratch.

Then you’ll understand the anger of the neglected Brazilian masses here.