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January 2003, Vol 93, No. 1 | American Journal of Public Health 44-48
© 2003 American Public Health Association

INTERNATIONAL PERSPECTIVES FORUM

Health Reform in Brazil: Lessons to Consider

Paulo Eduardo M. Elias, PhD and Amelia Cohn, PhD

The authors are with the Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.

Correspondence: Requests for reprints should be sent to Paulo Eduardo M. Elias, PhD, Departamento de Medicina Preventiva, Faculdade de Medicina da USP, Av Dr Arnaldo 455/2°, 01246-900 São Paulo, SP—Brasil (e-mail: pemelias{at}usp.br).

US analysts and decisionmakers interested in comparative health policy typically turn to European perspectives, but Brazil—notwithstanding its far smaller gross domestic product and lower per capita health expenditures and technological investments—offers an example with surprising relevance to the US health policy context.

Not only is Brazil comparable to the United States in size, racial/ethnic and geographic diversity, federal system of government, and problems of social inequality. Within the health system the incremental nature of reforms, the large role of the private sector, the multitiered patchwork of coverage, and the historically large population excluded from health insurance coverage resonate with health policy challenges and developments in the United States.




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