For 90%, Brazilians are unable to pay quality doctors, says research

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Although most Brazilians mostly use the SUS (Unified Health System), where treatment is free, economic issues have entered the list of Brazilians’ main health concerns in the last year, according to a survey by Ipsos released this week.

Brazil had the highest percentage of people in the world who say that the population does not have the financial conditions to pay for good quality medical care – 90% of respondents have this opinion. The global average in this regard is 58%.

The perception that the population cannot afford quality medical treatment is also high in other Latin American countries such as Colombia (83%), Chile (81%), Peru (81%), Mexico (80%) and Argentina ( 80%). The survey asked respondents to say whether they agree or disagree with the statement “many people cannot afford medical care in my country”.

Other countries where this perception is also high are South Africa (83%), Hungary (80%) and Russia (76%). But none of them on the same level as Brazil.

The countries where a minority agrees with the statement were nations where there is a strong public health system, such as the United Kingdom and Germany, where 37% have this opinion. The rate is even better in the Netherlands and Canada (33%), South Korea (26%) and Sweden, where only 19% think that many people in their country cannot afford quality healthcare.

The Global Health Service Monitor 2021 survey was conducted in 30 countries and polled 21,513 respondents, aged between 16 and 74 years.

Most Brazilians who responded to the survey –51%–, carried out between August and September 2021, also pointed to the lack of investment as one of the main problems faced by the health system in Brazil. After that, the most cited were the lack of investment in preventive health – an issue mentioned by 50% of those interviewed – and access difficulties and long waiting periods – mentioned by 45%.

On the global average, the main problems mentioned are difficulties in accessing treatment and long waiting periods (41%) and lack of staff in health institutions (39%). The cost of treatments was in third place (31%).

About 30% of respondents in Brazil consider health care in the country –both public and private– excellent or good. It is one of the worst performers – the global average is 53%. Singapore reaches 78% in this regard, and Australia and Switzerland, 78%.

“We see the impact of the economic issue in comparison with last year’s survey”, says Fabrizio Maciel, director of the health research area at Ipsos in Brazil. “This is reflected in other aspects as well, such as the growing concern about mental health. The crisis, financial worries, inflation and insecurity exert enormous pressure on people’s mental health.”

Mental illnesses were the second most cited health problem among Brazilians this year, mentioned by 40% of respondents – an increase of 13 percentage points compared to the survey conducted in the same period last year, according to Maciel. “And last year it had already increased compared to the previous year, without a pandemic.”

Concern about mental health was second only to concern about Covid-19, cited by 84% of respondents. Worldwide this rate is 70%.

On the world average, mental health is mentioned by 31% of people. The country where this concern is greatest is Sweden, where 63% mentioned the problem.

Despite increased concern about mental health in 2021 and 2020, research done so far shows that the pandemic has not actually increased the incidence of mental disorders in the population.

A study published by the scientific journal Lancet earlier this year, for example, studied suicide trends in cities or regions in 21 countries, including Brazil. The survey did not identify an increase in cases during the pandemic.

Researchers consulted by BBC News Brasil said that the diagnosis of mental disorders did not increase significantly during the pandemic.

Low quality

Other health problems most cited by respondents by Ipsos in Brazil were cancer (31%), stress (22%) and drug abuse (22%).

Maciel says that, in general, the evaluation of Brazilian respondents regarding the quality of what they have in question today is negative, worse than the world average.

“And this is not restricted to the Public Health System – the survey measured satisfaction with both the private and the public network”, says Maciel. “The issue of quality of treatment is a factor that has become quite accentuated. With the whole issue of the Prevent Senior (health plan) this year, it was clear that it is a problem that also affects the private network.”

The senior health plan operator is being investigated for a series of allegations involving the treatment of patients during the pandemic.

The Global Health Service Monitor 2021 survey was conducted from 20 August to 3 September 2021 with 21,513 respondents in 30 countries. It was done online, so it is representative of the population with internet access – which in Brazil is around 70%.

The margin of error for the country is 3.5 percentage points. The percentages add up to more than 100% because several questions had multiple-choice answers.

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