The Brazilian health system
“Health has never been treated as a priority in Brazilian state policy. During the last 28 years of the SUS, financing has never stopped being discussed as a problematic issue,” said Aquila Mendes, professor of health economics at USP. Despite the evolution of the Brazilian health system, it is still far from being among the best health systems in the world. Indeed, the Brazilian health sector is synonymous with inequalities in the country. On the one hand, the public sector, allowing almost 70% of the Brazilian population to be treated thanks to the social protection regime and the public health insurance INSS, making health care almost free. However, the medical infrastructure is less technologically developed, the health staff is less qualified and access to care is limited due to the unequal distribution of patients between the public and private sectors. This is especially true since
there are more private than public infrastructures in Brazil (60% of the infrastructures are private against 40% public out of just under 6000 hospitals), even though they accommodate only 30% of the Brazilian population. This means that there is often a long waiting time for a consultation with a public practitioner. How does the Brazilian health system work?
The health system in Brazil is regulated by the Ministry of Health and is financed by the state budget. Whether you are an expatriate or a citizen, if you are employed in Brazil, you must join the Brazilian social security system: the INSS. A share of contributions is deducted from your salary and directly deducted from your pay slip. There is also a social insurance system in place that provides free access to care for the elderly, disabled and those who can no longer work. Brazil has set up the Unified Health System (SUS) which allows the part of the Brazilian population not covered by social security to access free health care. The SUS covers many services and treatments including
Mediation ; Meditation, yoga and other alternative therapies; Breast milk banks; HIV pre-exposure prophylaxis Sex change surgery Hepatitis C treatment Copper IUD HPV vaccine Medicinal plants
According to the Brazilian Institute of Geography and Statistics, 7 out of 10 Brazilians depend exclusively on SUS in 2019. This means that less than 30% of the Brazilian population is affiliated to a private health insurance and can only be treated in the public sector without the possibility of access to complementary care.
However, this free health care system has its limits, as access to this care is limited because on the one hand the health staff in public hospitals is overwhelmed by the number of patients. On the other hand, the quality of care is very limited and inferior in comparison with the medical infrastructure of the private sector. In fact, not all Brazilians have access to this free care because the demand is far too high. According to DataSUS, in 2014, 707,000 Brazilians died from diseases considered preventable (deaths from influenza, tuberculosis or intestinal infections). How do I consult a general practitioner or specialist in Brazil?
In Brazil, you are free to choose your doctor, and your embassy will be able to recommend a list of doctors located in the same area as you. You can also ask your friends and family to recommend a general practitioner once you are in Brazil.
In Brazil, it is not necessary to obtain a prescription from your GP to consult a specialist. However, the demand for specialist consultations is much higher than the number of specialists in Brazil. Pharmacies in Brazil
In Brazil you will have no difficulty finding pharmacies, they are well equipped and are subsidised by the government which means that they offer medicines at low prices. In theory, some medicines are only available on prescription from a health professional. In practice, however, this rule is not widely enforced, which means that you can pick up almost any medicine in a pharmacy whether you have a prescription or not. Brazilian pharmacists will also be able to give you diagnoses and vaccinations. The regularisation of medicines sold in Brazil is still quite low, we advise you to be careful with the medicines you are given, they should have a red band on the box with the words “Venda sob prescrição Médica”. The pharmacies of the “Droga Raia” chain are open 24 hours a day.
The emergency service in Brazil
If you want to contact the emergency service in Brazil, dial 192. However, you will not necessarily find a service with an English-speaking person.
The emergency service is available throughout the country and is free for all inhabitants. In practice, the service is less good and reliable, often quite slow. In addition, when you are transferred to an emergency department within a hospital, you will most likely have an interminable waiting time there. However, you can also contact a private ambulance which will transfer you to a private hospital where the treatment will be much faster and the waiting time much shorter than in the public sector. Here is a list of emergency numbers for private hospitals in major cities in Brazil: Sao Paulo: Albert Einstein Hospital (3747-1000) / Samaritan Hospital (3824-5000) Rio de Janeiro: Copacabana (2257-6060) Brasilia: Vida Ambulance (3248-3030) The cost of paramedical care in Brazil
In Brazil, a consultation with a paediatrician costs between 190R$ and 250R$ per appointment. Many factors influence the price of a consultation with a paediatrician, such as the region, the type of care and the specialty of the professional you consult. Among the main symptoms that these specialists face in Brazil are:
Feeding errors; Lack of appetite; Low weight or short stature; Abdominal pain; Constipation or diarrhoea; Nasal obstruction; Bronchitis; Allergies; Breastfeeding guidelines.
It is advisable to have your child monitored by a paediatrician from birth until the age of 19.
Visits to an ophthalmologist should be fairly regular for everyone. There are many eye diseases that can be identified and treated after a consultation with an ophthalmologist. During a consultation with a specialist in Brazil, the assessment of your eye health will not be limited to the question of whether or not you should wear glasses. He or she will give you a complete eye analysis including tests such as refraction, fundus, monitoring of your intraocular pressure and clinical assessments of diseases such as cataracts and glaucoma. In general, the cost of a consultation with an ophthalmologist ranges from $90 to $200. However, in the most popular clinics, the cost of a consultation ranges from $300 to $600. The cost of a consultation with a physiotherapist generally ranges from $80 to $230, although you can find consultations for $60 and others for up to $300. This service is increasingly requested by Brazilians, especially those who have been working in the same job for a long time or who suffer from chronic pain. Maternity in Brazil
According to the AMB (Brazilian Medical Association), a full maternity ward in a private clinic costs an average of R$15,000. This cost includes the fees of the obstetrician, assistant, anaesthetist, paediatrician and neonatal intensive care unit. However, this value is only a basis on which you can make your estimates. It is advisable to draw up a birth plan yourself, listing everything you will need when you give birth. You will need a lot of things and therefore look for costs. Depending on your choices, you can make your maternity ward more affordable or more expensive. The main factors to consider when planning your maternity and their costs are
The type of birth (normal, natural or caesarean); In a normal birth you will give birth using traditional medical intervention methods such as epidurals, in a natural birth only natural methods will be used during your birth such as hot water baths and massages to relieve the pain. Finally, a caesarean delivery is much more expensive than the others (55% of deliveries in Brazil are done by caesarean). Anaesthesia; Anaesthesia includes the cost of the anaesthetic and the anaesthetist’s fees. Hospitalization or maternity costs; These costs vary depending on the hospital chosen, the structure of the room during the stay, the delivery room and the care infrastructure. Is it necessary to take out private expatriate health insurance in Brazil?
When relocating to Brazil, it is recommended that you take out private expatriate health insurance as it will provide you with cover for private sector healthcare costs.
If you are employed in Brazil, you can join the SUS, the Brazilian universal health insurance. However, it will only cover you for public health care. Public sector care is not recommended if you can afford private international health insurance. This is because the public health sector is very limited, due to the fact that access is very difficult as the demand is much higher than the capacity to care for it. This creates extremely long waiting times for a consultation, for example. If you are treated in an emergency room, you may have to wait several days for a doctor to see you. The quality of care is very average or even poor in some public institutions. The health personnel are less qualified and the hospitals are much less equipped than in the private sector. So yes, it is highly recommended to take out private insurance and as an expatriate, international insurance for Brazil offers many advantages and allows you to go to the private sector whenever you need health care. Waiting times are much shorter, health care staff are much more qualified, doctors have graduated from the best universities in Europe and hospitals are equipped with state of the art medical equipment. What private expatriate health insurance should I take out in Brazil and for whom? A person of non-Brazilian nationality can benefit from a private international health insurance for Brazil. It will cover you more comprehensively than local insurance by including countries outside of Brazil. Health insurance is compulsory in some cases depending on your profile, such as for people going on a PVT. Many self-employed people start an economic activity in Brazil in order to create new markets. If this is your case, to ensure that you obtain your permanent visa, it is essential that you take out private international health insurance. This insurance is also essential to allow you to treat yourself privately. If you are a nomadic worker, as is the case for more and more workers since Covid-19, when you apply for a digital nomadic visa for Brazil, you will be asked for health insurance valid in the territory. This is why it is compulsory in your case to take out health insurance, and more than recommended to take out private international health insurance that will cover you both in Brazil and abroad when you travel. If you are European and wish to go on holiday in Brazil for less than 90 days, it is also advisable to take out travel insurance such as Travel Pass which will cover you for private care as public care is of low quality and covers far less medical treatment than private care. If you are an expatriate in Brazil, whatever your profile as an expatriate, it is strongly recommended that you take out private international health insurance, also known as “expatriate insurance”. Whether it is the duration of your expatriation or the waiting period if you wish to join a local insurance, you must be affiliated to a private international health insurance before your departure. If you are a student going to Brazil for a semester or part of your studies or for an internship, it is mandatory that you take out an international health insurance policy. On the one hand, to obtain your student visa such as the Vitem IV and on the other hand, so that you can enjoy your student experience to the fullest without worrying about the cost of private healthcare which will be covered by an international health insurance policy such as GoldStudent Our GoldExpat international health insurance is perfectly suited to your profile whether you are an entrepreneur, a nomadic worker, an expatriate employee or a retiree.
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