FIFA World Cup and the Brazilian Healthcare System

When you finish your first year of medical school, you are filled with an immense sense of relief and an overwhelming need to go lay on a beach for the entire summer without a care in the world. Your soul cries out for that. Your brain needs rest without stress or a feeling of guilt that you aren’t doing something more productive with your time. However, as you think about all of the wonderful, exciting adventures you will embark on that summer, the guilt slams back into place when you realize this is your last real summer. Residencies will want to see that you did something medically and scholastically meaningful. You grumble and fret over how unfair life is before sitting down and begrudgingly mapping out your summer plan for medical success and enlightenment (while wistfully thinking of rolling waves and the sunlight you have missed during the school year).

All of these thoughts went through my mind this summer, and looking back I feel like I could have done more in the way of scholastic and clinical enrichment. I worked with MedEx Academy at the hospital, helped a professor perfect his teaching website, and shadowed a lot. But, with the thought of ‘last real summer’ bolded and flashing in the back of my mind, I made sure to make time for activities that were relaxing and enjoyable, such as family vacation. It is completely and totally necessary to calm down between M1 and M2 year if you want to hang on to your sanity, and I don’t regret going on vacations.

The most spontaneous form of unwinding I did was to randomly buy a ticket to the World Cup in Brazil at the very last moment possible. I had to rush and scramble to get everything done before flying down there, which was stressful in itself. But, I was going to the World Cup! As I played soccer for many, many years, that had been a dream of mine! I got to attend the Netherlands versus Costa Rica game and see how a country that actually appreciates the sport reacts. I’ll tell you, I was not disappointed with the excitement level. It was an invaluable experience, and I look back on it glad that I took the time to go when I was able.

However, I did manage to gain some medical enlightenment when I was there. I stayed with a friend who lived with my family for a year in high school as an exchange student. She and her two sisters are in medical school in Brazil and were actually in the middle of their studies while I was there. Not only did I get to see how their medical education differs from ours, but I got an insider’s look into the Brazilian healthcare system. It is very similar to what the new healthcare plan is pushing for, and it is failing in Brazil which was very concerning to me.

I don’t profess to be an expert on healthcare systems or healthcare reform. I know very little about it all, and I doubt that my friend had a firm grasp on her healthcare system. There are a lot of major differences between our countries in general that could be the deciding factor between a failed system and a successful one. Regardless, I found what she had to say interesting.

If you watched international news before and during the World Cup, you may have seen coverage of widespread protests against the FIFA World Cup in Brazil. You might ask, “why would the people of Brazil, who adore soccer, not want the World Cup to be held in their country?” Everywhere I went I saw spray painted walls saying things like, “we don’t need FIFA.” The basis of these protests lies primarily in government corruption and the cost of hosting such a large international event. Brazil has a lot of financial problems. Many citizens were mad that the government agreed to host this World Cup and pour billions into building massive stadiums that would never be used again instead of putting that money toward education, sanitation, and healthcare.

The healthcare system in Brazil, as I understand it, is meant to provide medical care at no expense to everyone that requires it. Everyone receives every consultation, test, surgery, etc. for free regardless of where they live, their income, their job status, or their nationality. (Non-citizens are treated the same way.) Resources are provided on a first come first serve basis. I think that’s great, and my friend agreed. It has opened up access to so many more people, and the population is benefiting from it.

As in our system, there is the option of private insurance and more quality healthcare for those that can afford it. However, the government is supposed to front the cost for this universal healthcare. The problem they are now facing is a lack of funds to support such a huge mission for such a large, densely populated and disperse country. Everyone in Brazil can see a physician, receive a diagnosis, and be given a prescription for medication. However, that does not guarantee that the medication will be available because there is not enough money to supply all pharmacies in the country with every type of medicine. People expect treatment and are faced with pharmaceutical shortages. This also goes for medical equipment. Medical equipment is expensive, and there aren’t enough funds to supply every hospital with the latest medical machinery. There are medical centers that don’t have basic MRI or X-ray machines. This is particularly true of rural areas. Physicians have been charged with treating everyone, but they don’t have the resources they need to accomplish this task. Also, as a tropical nation, there are many diseases that are still incurable in Brazil that require research into treatment. But, there is no money to support research either, so countries like Brazil have to rely on the labs of foreign countries to discover cures.

My friend ranted about this system for well over an hour. She really liked the idea of universal healthcare and believed healthcare was a right for all people. Her anger was directed at her government for monetary corruption and a lack of general understanding of healthcare itself. Though she was enjoying the World Cup, she couldn’t help but think what good those billions would have done her country if they had been used to address other national problems. When the 2016 Olympics were brought up, she refused to talk about it. Also, while I was there her aunt arrived and was to stay with my friend’s family for a couple of months. She is from a rural area over 16 hours from Salvador and has been diagnosed with Parkinson’s disease. She has to travel that far to a large city to receive treatment for her illness.

It was very interesting learning about another healthcare system from someone who was living with and working in it. As she was speaking, I was drawing vague connections to the new healthcare system on the horizon in this country and the problems it may face. I couldn’t help to think that we could learn from the problems being faced in Brazil. I don’t know enough about our new healthcare system, and no one can really foresee where it will lead. We don’t know the consequences of it, but most would agree that it is a step in the right direction. There are good points about the bill, but it has room for improvement. I think that an understanding of the successes and failures of other systems around the world are necessary to develop a system that works. Also, you need to compare countries of similar governments, wealth, development, disease and population to really make a good prediction.

Here is a link to an article about the Brazilian healthcare system and how our country can learn from it. I didn’t want to take my friend’s word on their situation without some form of evidence. This article is titled ‘What the US Can Learn from Brazil’s Healthcare Mess.’ It is a good read, published in The Atlantic and linked to a site for Harvard University’s School of Public Health. It was published in May 2014, so it is a good representation of healthcare in present day Brazil. There is also a slightly older publication by the WHO in 2008 representing how this system was viewed in that year. It is titled ‘Flawed but Fair: Brazil’s health system reaches out to the poor.’ They both demonstrate the good qualities of the Brazilian system and the areas that they need to work on. They point out a lot of surprising similarities in our countries, and they bring to light more than what my friend mentioned. Many of the things in the recent article are fears I’ve heard expressed by both physicians and patients in this country when looking toward our future healthcare.

http://www.theatlantic.com/features/archive/2014/05/the-struggle-for-universal-healthcare/361854/
http://www.who.int/bulletin/volumes/86/4/08-030408/en/

Tori Seigler

I am from North Augusta, South Carolina, and I am a born and bred Carolina girl. When it came time for college, I happily made my way to Columbia to attend the University of South Carolina (USC). I started college in Biomedical Engineering because I figured it would be an acceptable fall back plan. The only problem was, I forgot just how dismally boring the combination of calculus and physics could become. Also, all of my medical volunteering and biology classes made me realize that medicine was actually the best match for me. I loved it. So, I made one of the more difficult decisions I’ve had to make in life and switched to biology, committing myself to a medical track. Graduating from USC with a major in biology and minor in chemistry was a big moment for me, because I was among only two or three people in my uncommonly large extended family to receive a college degree. And, I was the first to be going on to further my education. I am very excited to be starting my medical education here at USC School of Medicine Greenville on behalf of my family and myself. It is going to be an adventure and it will be difficult, but my experience here so far has made me feel that I definitely made the right choice.