Opinion – Saúde em Público: “Efficiency in the SUS”: response from the authors of the book “SUS: the debate around efficiency”

On December 26, 2022, the blog Saúde em Público, from Folha de S. Paulo, published an article by Ricardo de Oliveira, making comments on our book, “SUS the debate around efficiency”, published this year by Fiocruz Publisher.

Despite the complimentary considerations – which we are expressly grateful for – the article is mistaken, distorting its purpose.

As the debate on efficiency in the Unified Health System (SUS) is of public relevance and can help formulate, execute and evaluate health policies, we would like to make the following clarification to the readers of this prestigious journal.

One of the main premises of our book is that efficiency in some instances in the SUS is hampered by the lack of funding in the system. This is completely different from saying that eventual inefficiencies cannot or should not be evaluated, measured and overcome.

Thus, we are surprised by the consideration attributed to us “(…) that underfunding does not allow evaluating the efficiency of the application of resources in the SUS”.

This was never said: on the contrary, in the book’s presentation itself, we stated “our interest in examining efficiency in the SUS”.

It should be noted that we have already produced numerous works on the evaluation of efficiency in the SUS and in other health systems, including in books and national and international scientific journals. It would therefore be pointless to write a book about a hot topic on the public policy agenda, if we thought that it would not be possible to assess the efficiency of the application of resources in the SUS.

We are open to the exercise of criticism and self-criticism, however, at that moment, it seemed important to us to make clear our interest in evaluating the efficiency of the Brazilian health system, as well as contributing to the technical-scientific development of this method, without renouncing the constitutional assumption that health is a social right in our country.