More Doctors, More Problems: Exploring Brazil’s Mais Médicos Program and the Legal Challenges it has Provoked

Abstract

Brazil is among the growing number of countries that guarantee the right to health. Its Constitution provides that the state has a duty to implement policies that promote universal access to health care services, with the ultimate goal of improving the health outcomes of all Brazilians. Despite this constitutional guarantee and the creation of the Unified Health Service to facilitate its realization, access to health care services and medical personnel is unevenly distributed across the country, with a high concentration of physicians in wealthier urban zones and a comparatively low density of medical personnel in impoverished urban and rural areas.

In response to widespread public dissatisfaction with the state of access to health care in Brazil, President Dilma Rousseff introduced the Mais Médicos program in July 2013. The program provides for a range of measures to improve the provision of health care throughout the country; however, criticism of the program has been widespread and varied.

Given the controversy surrounding the program, it is probable that litigation over its legality, particularly the validity of importing foreign doctors, will determine the fate of Mais Médicos. This Note argues that the Supreme Federal Court’s recent jurisprudence, as well as its apparent commitment to challenging the status quo and promoting the rights of traditionally disadvantaged and marginalized members of Brazilian society, indicates that the Brazilian judiciary will likely uphold the Mais Médicos program, including the controversial provision that calls for the importation of foreign medical personnel. At the same time, it also suggests that more needs to be done in the long-term to resolve the health care system’s inequities. Part II gives an overview of the constitutional and ideological foundations of the right to health in Brazil and provides an account of the current state of access to health care at both the national and regional levels. Part III outlines the basic measures established under Mais Médicos, focusing on the importation of foreign doctors, and describes the public’s response to the program, namely the most ubiquitous criticisms. Part IV considers the likely future of Mais Médicos through the lens of the Supreme Federal Court, first considering past litigation over the right to health in the Brazilian legal system and then looking to the recent string of socially and politically liberal decisions that have defined the court in recent years.

Keywords

Mais Médicos, Universal Health Care, Health Law, Access to health care

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Authors

Julia Cammack (Washington University in St. Louis, School of Law)

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