Idea is to remake Mais Médicos without foreigners, says Humberto Costa

Senator Humberto Costa (PT), who is among the coordinators of the health thematic group in the transitional government, said that resuming the Mais Médicos program, created in 2013 under Dilma Rousseff (PT), without using professionals abroad, is under discussion. to supply the demand of less assisted regions.

“You now have a greater training of doctors in Brazil than there used to be”, he justified. “There are many Cuban doctors who stayed and are not practicing their profession, we have to see if there is a solution for this. There are many Brazilian doctors who took a course abroad and did not revalidate their diploma.”

The former Minister of Health of the now president-elect Luiz Inácio Lula da Silva (PT) also stated that the transition team is studying the use of the private network to end the SUS (Unified Health System) queue — a campaign promise by the PT .

Although the SUS queue has been a bottleneck for years, it was impacted by the arrival of Covid-19, which affected the performance of procedures in several areas. Such as Sheet showed, there was a decrease of more than 900 million calls and actions in a year and a half of the pandemic.

Costa also said that the budget recomposition of the SUS, affected by the spending cap, the recovery of the PNI (National Immunization Program) vaccination rates and the expansion of the use of telehealth will also be part of the priorities.

In addition to the senator, doctors Alexandre Padilha, Minister of Health in the first Dilma government, between 2011 and 2014, are part of the transition group; José Gomes Temporão, Minister of Health in Lula’s second term; and Arthur Chioro, who was also Dilma’s minister between 2014 and 2015.

What will be the priorities of the technical health team? The first priority is budget recomposition. On account of the PEC of the Expenditure Ceiling [de 2016]we currently have a gap of approximately R$ 22 billion in what should be the health budget for 2023. Apart from that, our priority is to guarantee the supply of medicines, vaccines and SUS supplies.

How is the shortage? We are running a great risk of widespread shortages. Whoever enters in January to assume the ministry needs emergency actions to make this possible. In the transition, we will have to open paths to carry out pre-negotiations and a survey of where to buy these medicines and vaccines. We will try to negotiate and then formalize it from a legal point of view.

What are the other priorities? We intend to start a strong effort to recover the PNI, which was once the best in the world. Today we are on the verge of having already eradicated diseases reappearing due to low vaccination coverage, as is the case with polio. Bringing vaccine coverage to acceptable numbers in a short period of time requires an advertising campaign, using important personalities in the health area. I can’t speak for another area, but I will probably go back to the conditions for receiving the Bolsa Família program, such as the updated vaccination card and prenatal care for pregnant women.

Another important point is to start making the first investments in the issue of digitization of the SUS [telessaúde]🇧🇷 There is also the priority of carrying out a joint effort to reduce the pent-up demand for procedures due to the pandemic. The idea is to organize states and municipalities to reduce this queue, including buying private services.

Do you already have a diagnosis of this queue? There isn’t, just as we don’t know exactly how the shortage is. We are talking based on information from state, municipal, population, medical societies. The Popular Pharmacy would be a little involved in this issue of drug shortages. The idea is to recompose the resource and, from what I have seen the president say, is to expand the offer. Today insulin is available, but there are new models that control better and are more modern.

Could it be an expansion via modernization? It could be modernization, it could be the expansion of other medicines, it could also be the expansion of the range of diseases [atendidas]🇧🇷

Mr. talked about using private services to eliminate the SUS queue, but what would change given that the government already makes this use? Today you have services that are accredited by SUS, Santas Casas, private institutions. There is a large margin of private services in even idle places where there may be a call to join this task force. Obviously, values ​​and legal ways of doing things will be discussed.

Would the expansion of the purchase of private services be at the beginning of the government or throughout the administration? Initially, it is to face this repressed demand, this collective effort. I have always been a defender of the idea that the SUS can buy or exchange services with the private sector where there is idleness. For example, the SUS has a serious problem with specialized care, consultation, examination. On the other hand, there is [privado] in which there is health insurance, hospital idle for consultation, examination.

There is also the idea of ​​creating More Specialists. What would that be? It is for you to expand the offer of specialized services. What are the main causes of death in Brazil today? It’s cardiovascular disease, it’s cancer, and then comes the so-called external causes. Today it may take you a year to have an appointment with a cancer specialist. The idea would be to make public calls.

Today a considerable part of the health budget is reserved for rapporteur amendments. How to work it? I think the secret budget solution must be global. The idea is that this ceases to exist. The Executive cannot abdicate the budget execution, hand it over to the National Congress. If the Supreme [Tribunal Federal] say that the secret budget is unconstitutional, this resource will go back to the budget of each ministry, which will apply according to their plans.

And the nursing floor? The government is committed to ensuring, it would enter a context of various resources that need to be resolved by the government. The idea is that the amount meets the health budget, but the source of payment would be another.

Mr. talked about telehealth. What’s the best model? There is a bill that makes several predictions. The first is that, if the doctor or patient wants telehealth care, it will be done. There are certain things that you can do yourself, there are others that are best done within the health unit, for example. A specialized consultation is important to be carried out within a basic health unit with the help of a nurse who will receive a recommendation from the doctor who will be attending via telehealth.

Will the Mais Médicos program return at the beginning of the government? We don’t have anything in-depth, the important thing is to make it possible to offer doctors in regions where there are gaps in care. The idea is to remake the program. The intention, in principle, is not to bring doctors from abroad. Today you have a greater training of doctors in Brazil than there was in the past.

Would it be possible for doctors to come from other countries despite not being a priority? At first, no. There are many Cuban doctors who stayed and are not practicing their profession, we have to see if there is a solution for this. There are many Brazilian doctors who took a course abroad and did not revalidate their diploma. Would there be any incentive to revalidate? There are several alternatives, nothing is defined.

Will there be any special look at Covid? First to complement the vaccination, second to attend to the sequelae and third to study Covid itself because it has sequels that we don’t even know about.