EUA: Sistema de inovações bem-sucedido e sistema de saúde caro, com baixo acesso da população

EUA: Sistema de inovações bem-sucedido e sistema de saúde caro, com baixo acesso da população

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Telão com imagem do pesquisador à esquerda e tela de sua apresentação à direita

O estudo apresentado na oficina CEIS 4.0 sobre os EUA mostrou o quanto o sistema de saúde americano é caro sem que atenda a toda população. “O PIB do Complexo Econômico-Industrial da Saúde é estimado em cerca de 4,5 trilhões de dólares, o que é bastante significativo”, mostrou o pesquisador Rodrigo Sabbatini, da Facamp – Faculdades de Campinas, integrante da Rede CEIS 4.0, à frente do estudo, ao lado do pesquisador Saulo Abouchedid, da mesma instituição. “Isso é uma característica importante do sistema de saúde daquele país, que é muito caro e ao mesmo tempo muito restrito em termos de acesso e muito concentrado em termos de repartição dos ganhos econômicos em prol do setor privado”, analisou.

Conforme contabilizou Sabbatini, o CEIS americano emprega cerca de 16 milhões de pessoas e, em relação a faturamento, alcançou, em 2022, quase 1 trilhão de dólares nos subsistemas de base químia e biotecnológica e de base mecânica, eletrônica e de materiais, com exportações de 146 bilhões de dólares e déficit comercial “bastante expressivo”, de mais de 100 bilhões, “porque há muito outsourcing [relacionado à contratação de serviços e recursos externos], sobretudo, na produção de fármacos e equipamentos”.

Já os gastos em pesquisa e desenvolvimento (P&D) atingem 245 bilhões de dólares, sendo 166 bilhões, só na indústria farmacêutica, apontou. Quando feita a média dos dois subsistemas, esse valor represnta pouco menos de 12% do faturamento. Dados esses valores, Sabbatini destacou que os gastos em saúde per capita nos EUA é quase o dobro da média da OCDE, ainda que a qualidade da cobertura seja limitada. “Pouco menos de 17% do PIB”.

O pesquisador sublinhou que a atenção à saúde ao norte-americanos é “extremamente privatizada”, com pouca participação do setor público. “O CEIS americano custa muito caro, é muito eficiente em termos de desenvolvimento tecnológico, de ganhos econômicos para o setor privado, mas atende de maneira muito ruim à população”, sintetizou Sabbatini. Em sua avaliação, o sistema de saúde americano consegue ser pior” do que aqueles de grande parte dos países de renda média em desenvolvimento. “O SUS, perto da ausência do SUS nos Estados Unidos, é uma das sete maravilhas da humanidade”, comparou.

Em relação a aspectos positivos do Complexo Econômico-Industrial da Saúde nos EUA, Rodrigo destacou o sistema nacional de inovações, “talvez o mais bem-sucedido e o mais complexo de todos os segmentos econômicos”, afirmou, comparando com os já estudados por ele em décadas como pesquisador. “Só no National Institutes of Health, que é como um vasto complexo de Fiocruzes nos Estados Unidos, foram destinados quase 190 bilhões de dólares em financiamento e produzidas centenas de novas drogas, em termos tanto de pesquisa aplicada, como em pesquisa básica, isso só para a área de farmacêutica”, com grande transferência para o setor privado”, apontou.

Essa transferência de recursos públicos ao setor privado resulta em grande impacto no desenvolvimento tecnológico de fármacos e de outros produtos e serviços da área de saúde, como observou Sabbatini. “Todo o resultado desse desenvolvimento tecnológico ímpar fica restrito a uma pequena parcela da população, que tem acesso a planos de saúde, extremamente caros”, disse. “Por um lado, você tem um caso muito bem-sucedido de interação público-privada, por outro, um caso terrível para o desenvolvimento socioeconômico como um todo e, sobretudo, para a defesa da vida – a missão que nos colocou lá atrás o Carlos Gadelha [secretário do Ministério da Saúde e coordenador geral do projeto de pesquisa CEIS 4.0] e que estamos defendendo aqui”.

Rodrigo pontuou, dessa experiência americana, o que pode servir de inspiração para o CEIS do Brasil. “Se conseguíssemos adaptar esses arranjos institucionais que são extremamente complexos e, sobretudo, um nível de financiamento que é realmente muito maior do que aquele que nós temos, se conseguíssemos ampliar esses níveis de financiamento, se pudéssemos reproduzir, de alguma maneira, em menor escala, essa complexidade, tanto do ponto de vista da institucionalidade, quanto do ponto de vista das contas públicas”, ressaltou o pesquisador, “não temos dúvida de que o Complexo Econômico-Industrial de Saúde no Brasil poderia cumprir esse destino tão desejado, que é ampliar sua capacidade de alavancar emprego e renda no país de maneira ainda mais significativa”.

 

Acesse as exposições dos pesquisadores da oficina

Oficina do CEE-Fiocruz discute o fortalecimento do Complexo da Saúde e do SUS em meio às transformações sociais, econômicas e tecnológicas

O piso e o teto: impactos do arcabouço fiscal para o financiamento da Saúde

Transformações tecnológicas na Saúde e no CEIS

Empregos no CEIS: potenciais e desafios

EUA: Sistema de inovações bem-sucedido e sistema de saúde caro, com baixo acesso da população

Índia: paralelos com o Brasil, incentivo à medicina tradicional, valorização da saúde digital e incentivo à pesquisa e à produção

China: articulação bem-sucedida entre acesso à saúde e desenvolvimento produtivo

Reino Unido: a importância do poder de compra do Estado e do programa de descarbonização

Mercosul: realidades diversas, desafios em comum

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