From Bolsonaro to Lula: The opportunity to rebuild universal healthcare in Brazil in the government transition.

This paper takes the government transition that took place between 2022 and 2023 in Brazil as a case study and aims to analyse how a cycle of radical right-wing populist government acted to dismantle Brazil's national health system foundations. It describes how governance was built based on political-clientelism and market-privatising interests and on the adoption of long-term fiscal austerity policies, whose results are public defunding and weakening and disorganisation of the country's national health system, with a significant worsening of health indicators and the capacity to respond to the population health needs. The lessons from recent experience in Brazil should serve as learning and a source of academic and political reflection, since there is an ongoing international movement and signs of rise of radical right-wing populist regimes in several countries, which endanger the Democratic Rule of Law, institutions, and social policies. It allows putting into perspective how political cycles of this nature can affect national universal health systems, including those that have experienced substantial progress towards universal access and universal health coverage. Keeping in mind the Brazilian experience, it was possible to observe the progressive structuring of a radical right-wing neo-populism and in the sanitarian.

How many and which physicians? A comparative study of the evolution of the supply of physicians and specialist training in Brazil and Spain.

BACKGROUND: In the face of the medical workforce shortage, several countries have promoted the opening of medical schools and the expansion of undergraduate and specialization education in medicine. Few studies have compared the characteristics and effects of expanding the supply of general practitioners and specialist physicians between countries. Brazil and Spain, two countries with distinct historical processes and socioeconomic scenarios, yet both with universal public health systems and common aspects in training and medical work, have registered a significant increase in the number of physicians and can be used to understand the challenges of strategic planning for the medical workforce. METHODS: This study provides a descriptive approach using longitudinal data from official databases in Brazil and Spain from 1998 to 2017. Among the comparable indicators, the absolute numbers of physicians, the population size, and the physician's ratio by inhabitants were used. The number of medical schools and undergraduate places in public and private institutions, the supply of residency training posts, and the number of medical specialists and medical residents per 100 000 inhabitants were also used to compare both countries. Seventeen medical specialties with the highest number of specialists and comparability between the two countries were selected for further comparison. RESULTS: Due to the opening of medical schools, the density of physicians per 1 000 inhabitants grew by 28% in Spain and 51% in Brazil between 1998 and 2017. In that period, Spain and Brazil increased the supply of annual undergraduate places by 60% and 137%, respectively. There is a predominance of private institutions providing available undergraduate places, and the supply of medical residency posts is smaller than the contingent of medical graduates/general practitioners each year. CONCLUSION: Both countries have similar specialist densities in cardiology, dermatology, and neurosurgery specialties. However, family medicine and community in Spain has 91.27 specialists per 100 000 inhabitants, while in Brazil, the density is only 2.64. The comparative study indicated the complexity of the countries' decisions on increasing the medical supply of general practitioners and specialist physicians. Research and planning policies on the medical workforce must be aligned with the actual health needs of populations and health systems.

Universal Health Care for the United States: A Primer for Health Care Providers.

The United States is one of a very few high-income countries that does not guarantee every person the right to health care. Residents of the United States pay more out-of-pocket for increasingly worse outcomes. People of color, those who have lower incomes, and those who live in rural areas have less access to health care and are therefore at even greater risk for poor health. Universal health care, a term for various models of health care systems that provide care for every resident of a given country, will help move the United States toward higher quality, more affordable, and more equitable care. This article defines a reproductive justice and human rights foundation for universal health care, explores how health insurance has worked historically in the United States, identifies the economic reasons for implementing universal health care, and discusses international models that could be used domestically.

Primary Care 2030: Creating an Enabling Ecosystem for Disruptive Primary Care Models to Achieve Universal Health Coverage in Low- and Middle-Income Countries.

Background: Forty years after Alma Ata, there is renewed commitment to strengthen primary health care as a foundation for achieving universal health coverage, but there is limited consensus on how to build strong primary health care systems to achieve these goals. Methods: We convened a diverse group of global stakeholders for a high-level dialogue on how to create an enabling ecosystem for disruptive primary care innovation. We focused our discussion on four themes: workforce innovation and strengthening; impactful use of data and technology; private sector engagement; and innovative financing mechanisms. Findings: Here, we present a summary of our convening's proceedings, with specific recommendations for strengthening primary health care systems within each of these four domains. Conclusions: In the wake of the Astana Declaration, there is global consensus that high-quality primary health care must be the foundation for universal health coverage. Significant disruptive innovation will be required to realize this goal. We offer our recommendations to the global community to catalyze further discourse and inform policy-making and program development on the path to Health for All by 2030.

Ensuring affordable access to healthcare for everyone in the European Union: What gaps remain and how can the EU support Member States to overcome them?

European Union (EU) Member States have made multiplecommitments to progress towards universal health coverage (UHC),so that everyone can access quality healthcare without experiencingfinancial hardship. Yet, significant gaps in all three dimensions ofhealth coverage (population coverage, user charges, and benefitspackages) remain. This article highlights some of these gaps, looks athow access to healthcare has been addressed through the EU’s socio economic governance and funding instruments, and suggests ways inwhich the EU can further support national progress towards UHC.