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Political and Institutional Drivers of Social Security Universalization in Brazil

In: Towards Universal Health Care in Emerging Economies

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  • Marcus André Melo

Abstract

Brazil’s experience in building a relatively successful universal health system was made possible by the combination of political incentives to serve poor constituencies, which made it politically sustainable; fiscal sustainability and the great extractive capacity of the Brazilian state; and the institutional capacity to run a complex decentralized system. This chapter argues that Brazil’s Unified Health System (SUS) has faced two important challenges: finding new financial resources for the sector and promoting efficiency gains. Finding new sources of funding has involved unprecedented political costs despite the increasing saliency of public health in the public agenda. Efficiency gains are also unlikely to occur in the near future due to the recent deterioration of public sector management since 2012 and other specific factors, including the judicialization of health care.

Suggested Citation

  • Marcus André Melo, 2017. "Political and Institutional Drivers of Social Security Universalization in Brazil," Social Policy in a Development Context, in: Ilcheong Yi (ed.), Towards Universal Health Care in Emerging Economies, chapter 6, pages 155-179, Palgrave Macmillan.
    • Handle: RePEc:pal:sopchp:978-1-137-53377-7_6
    DOI: 10.1057/978-1-137-53377-7_6
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