Publications IPH Magazine Annals of Summaries: 38th Congress of Hospital Administration and Health Management Interview with Valdesir Galvan, Chairman of FBAH

Valdesir Galvan - This Congress' main focus of discussion is the economic crisis the country is going through. So we focus so much on the crisis that we forget the great opportunity for the Health System. If you consider financing, the Public Health System in Brazil has been in crisis for quite some time. It is underfinanced and has been facing all these difficulties. That is why I see a great opportunity to get out of our comfort zone, since we are discussing this, and do things differently. If we don't change the way we do things, we are going to suffer the crisis more intensively. So we must look for other ways to manage, review processes, review models. Nowadays, I think Brazil needs to review its payment model in both public and private health services. I believe there should be a better partnership between private and public, a deeper integration. I think that the partnership between public and private health can contribute considerably to the public health system and, especially, to the payment model, the latter is not satisfactory for anyone. It is neither good for those paying it nor for those receiving through it, therefore, it is out of control. 

In the private system we have recently learned about the orthosis and prosthesis mafia, which is something that has always been there, at times in cardiology, others in orthopedic, and others in oncology. Since we have always had to face this situation, I think it is time to discuss the payment model. For a long time, hospitals have focused their gains on materials and medicines, forgetting about hotel services in hospitals. This was due to the fact that health insurance companies did not recognize that kind of work, hospitals' infrastructure didn't use to generate a lot of money, so hospitals have found their way with materials and medicines. 

From the public health point of view, under-financing is pretty clear. The SUS model, its prices, is due to fail because it is unfeasible nowadays. I don't know any institution that can survive on SUS, they cannot support themselves because the institutions are paid 30% of the costs. So if a procedure costs one hundred reais, SUS pays the institution only thirty reais back. This means the institution has to find a way to cover the remaining seventy reais to cover the cost. From the financing point of view, I think this is the big issue that the health system has to deal with right now to discuss this model. We also have the matter of access, not everybody has access to the proper health system. We see this on the media; there are queues, difficulties in scheduling appointments due to the lack of doctors. That is why I believe this is the time to review this model. In fact, the Federation has attended the Congress to discuss these models and the current situation. We, managers, have the responsibility to find a way out of this situation or at least to try to find a more comfortable situation.