The public-private relationship in brazilian health care: reflecting ethically on the impasses and tendencies to the brazilian national health care system

Abstract

This article brings a reflection on the public-private relationship on health care, trying to point out the tendencies and impasses experienced by the Brazilian Public Health Care System (SUS) and its ethical implications in daily life. Despite constitutional achievements, health as a fundamental right has faced some obstacles to its accomplishment; among them we find the international policies of economical adjustments. The State’s constitutional role, according to the neo-liberal logic, is transferred to the individuals and the community, so social welfare policies are reduced to compensatory and privatizing programs, increasing the numbers of vulnerable and socially excluded people. Facing this situation of theoretical and practical crises, the proposals of the “Bioethics of Protection” become an important reflection source, since it defends the search for a truly ethic State, which guarantees citizen rights achieved through the Constitution.