ABCDT (National Association of Dialysis and Transplant Centers) decided to enter as amicus curiae (friend of the court) in a lawsuit filed with the Federal Supreme Court (STF) that asks for the nullity of the law that established the national level of nursing.
The ADI (Direct Action of Unconstitutionality) was proposed by the CNSaúde (National Confederation of Health, Hospitals and Establishments and Services).
Sanctioned by President Jair Bolsonaro (PL), the law did not determine the source of funding for this salary increase for nurses, technicians and assistants. The measure creates a monthly floor of R$ 4,750 for nurses. Nursing technicians must receive 70% of this amount, and nursing assistants and midwives, 50%.
National entities representing the private health sector have warned about the cost of the salary increase, and some private hospitals are already studying dismissing employees, according to CNSaúde.
Associations of hospitals and health plans also met with the ANS (National Supplementary Health Agency) this week to inform the agency that the new law on the nursing floor will generate transfer of costs in the sector, with a possible impact on the final consumer, with rising monthly fees.
Based on the calculations that led to the ANS, the estimate is that the impact will reach R$ 16 billion in the public and private sectors.
For ABCDT, the reality of dialysis is the most serious in the entire Brazilian health system because 87% of renal patients in the country are treated by private clinics affiliated to the SUS, which were already facing a crisis due to the lack of readjustments of the SUS table.
The sector estimates that the amount paid for the system was already at least 32% below the costs of a dialysis session even before the new nursing floor.
According to the entity, a session today has an average cost of R$ 288. The SUS passes on R$ 218, a lag of R$ 70. Now, with the new floor, the next payroll of clinics will be 25% higher than the national average. .
According to the association, in clinics in regions of the country where salaries were much lower than the new floor, the increase in payroll reached 138%.
Today, there are almost 150,000 people being treated for chronic kidney disease in the country, with at least 3,000 waiting for a vacancy to undergo outpatient dialysis, according to ABCDT. There are about 800 dialysis centers operating in Brazil.
“Without funding source to pay for the increase [gerado pelo piso da enfermagem], immediately many clinics are no longer accepting new SUS patients. But soon, the clinics will have to close their doors”, says nephrologist Yussif Ali Mere Junior, president of ABCDT.
A survey by the association showed that 40 clinics closed their doors in the last six years due to the crisis of underfunding of dialysis treatment, which should worsen if the source of funding for the new floor is not defined, according to Ali Mere.
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