Trabalho, Educação e Saúde - TES (Work, Education and Health) is an open access scientific journal, edited by the Joaquim Venâncio Polytechnic School of Health, from Oswaldo Cruz Foundation.
The present essay is about problems in the Brazilian health system that originate from differences in understanding and practices of the relations between public and private spheres. The proposed hypothesis suggests that conserving political, institutional and financial arrangements for providing public support to private enterprises and HMOs is considered as important as implementing universal access to health. The article also analyses the argument that the existence of a private health sector and the financial aid given to assistance programs unburden the Unified Health System and, thus, lead to the efficient use of resources in providing care to those "who cannot pay". In light of recent information on tax-breaks and direct public expenditures destined to private HMOs, the author considers the possibility that a public health system for the poor may preclude the existence of the Unified Health System as proposed by the Brazilian Constitution of 1988.
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