Hospital managers in RS appeal for State intervention in the health crisis

The health crisis occupied the center of discussions at Federasul’s “Tá na Mesa” event this Wednesday. With the theme “The challenges of public health in Rio Grande do Sul: cross financing between SUS and Health Plans”, leaders such as Julio Flávio Dornelles de Matos, general director of Santa Casa de Porto Alegre, Luciney Bohrer, administrator of Hospital de Clínicas de Passo Fundo , Rogério Pontes Andrade, administrative-financial director of Hospital São Lucas at PUCRS, and Jocélio Cunha, president of Hospital de Clínicas de Carazinho, highlighted the difficulties and concerns faced in the sector.

They warned of an already foreseen health crisis in Rio Grande do Sul, highlighting the urgent need for State interventionlong-term public policies, reorganization of value transfers and increase in the Unified Health System (SUS) table to avoid an even greater escalation of the crisis.

The coordinator of the Federasul health working group, Luciano Zuffo, highlighted the importance of discussing the work of philanthropic hospitals in the State and the critical situation they face. Zuffo presented a survey carried out by the federation in 173 companies – 51% services 31% commerce 17% industry – which shows that 63% of companies do not have a health plan for employees and 72% do not have health promotion and prevention measures.

The data presented showed that SUS financing in Brazil is R$538.7 billion. This value is divided into 28.5% coming from the Union, 28.5% from the States and 43.1% from the municipalities. Of the SUS resources coming from the State, there are R$13.6 billion, 49.6% of which is allocated to hospital and outpatient care, 37.8% to basic care and 12.6% to other services. In the State there are 3.598 million health plan beneficiaries, 27.2% from IPE, 17.3% from Unimed Porto Alegre, 24.3% from state Unimed, 24.3% from Unimed federation and 31.1% from other plans.

Crisis was expected

The general director of Santa Casa, Julio de Matos, stated that the imposed crisis has been a reality predicted for years and recently worsened by the situation at the Cardiology Institute and, consequently, with the reduction of care in hospitals in the Metropolitan region. “The demands were not met and the overload came to Porto Alegre”, he explains. According to Matos, in 2023 Santa Casa served patients from 491 of the 497 municipalities.
Matos stated that hospitals are at the limit of their care structures. And it is necessary to review the situation around Porto Alegre, which is also operating at maximum capacity.

He also highlighted that the hospital is the last resort and that actions must start at the base, in primary care and in the lines of care for the assistance process. He considers that there is a need for State intervention and long-term public policy. The general director of Santa Casa observes that since the birth of the SUS, 30 years ago, public policies have been discontinued and “to be successful, a state health project is necessary, not a government one”.

The president of Hospital de Clínicas de Carazinho, Jocélio Cunha considered that the problem and difficulties are the same in all hospitals. He pointed out that SUS service in the municipality exceeded 80% and that the deficit generated last year was R$17 million. “We are heading towards a complex situation that is worsened by the situation at IPE Saúde”.

Financing in check

For the administrator of the Hospital de Clínicas de Passo Fundo, Luciney Bohrer, the biggest aggravating factor in the health crisis is the self-financing of the State’s philanthropic hospitals. He revealed that 127 philanthropic hospitals in Rio Grande do Sul owe banks the amount of R$ 1.6 billion and are responsible for more than 80% of services in the State.

Bohrer considers that the worsening of the crisis is also a consequence of closure of more than 80 hospitals in recent years. The administrator also warns about the possible increase in demand in the SUS due to the current situation at IPE Saúde. “We need to prepare for people who are going to leave IPE and go to the SUS queue”, highlighted Bohrer.

At the conclusion of his speech, Bohrer appealed to public agents and businesspeople to preserve the State’s philanthropic network. “These are really the ones who are at the forefront of saving the population of Rio Grande do Sul,” he said.

The administrative-financial director of Hospital São Lucas at PUCRS, Rogério Pontes Andrade, highlighted that the largest number of emergency services in the capital are classified as serious and that the epidemiological situation and the current health management situation are pressing for urgent change. He believes that one of the biggest problems facing philanthropic hospitals is the search for other sources of resources to make up for the SUS deficit.

Andrade recalled that care at PUCRS is 60% SUS and 40% health plans and that care in the area of ​​cardiology has practically doubled, in addition to care for neurological and cardiovascular diseases.