UNIVERSALITY, INTEGRALITY AND EQUITY: PRINCIPLES AND DILEMMAS OF THE SUS TODAY
DOI:
https://doi.org/10.56238/arev7n10-194Keywords:
Unified Health System, Universality, Comprehensiveness, Equity, Health Financing, Public PoliciesAbstract
The Unified Health System (SUS), established by the 1988 Federal Constitution, is based on the principles of universality, comprehensiveness, and equity, constituting one of the most comprehensive public health policies in the world. This research aimed to analyze contemporary dilemmas related to the effectiveness of these principles, considering the social, regional, and ethnic inequalities that plague Brazil, in dialogue with international experiences and interdisciplinary perspectives. A narrative literature review was adopted as the methodology, conducted in September 2025. The results demonstrate that universality faces practical limitations due to socioeconomic and territorial inequalities, which compromise the constitutional promise of equal access. Comprehensiveness, although strengthened by Primary Care, still faces fragmented care and insufficient coordination between levels of care. Equity, in turn, remains a central challenge, evidenced by the difficulties faced by indigenous populations and people with disabilities, who continue to face structural barriers to access. It is concluded that consolidating the principles of the Unified Health System (SUS) requires restructuring funding, modernizing interfederative governance, adopting redistributive policies, and incorporating technological and organizational innovations that make the system more adaptable and inclusive.
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References
BRASIL. Constituição (1988). Constituição da República Federativa do Brasil. Brasília, DF: Senado Federal, 1988.
CARVALHO FILHO, M. A. de; et al. Adopting a pedagogy of connection for medical education. Medical Education, [S. l.], v. 58, n. 4, p. 389-397, 2024.
D’ADAMO, I.; et al. Sustainalism: An Integrated Socio-Economic-Environmental Model to Address Sustainable Development and Sustainability. Sustainability, Basel, v. 15, n. 6, p. 2531-2549, 2023. DOI: https://doi.org/10.3390/su151310682
FREDRIKSSON, M. Universal health coverage and equal access in Sweden: a century-long perspective on macro-level policy. International Journal for Equity in Health, London, v. 23, n. 12, p. 1-15, 2024. DOI: https://doi.org/10.1186/s12939-024-02193-5
GRÉAUX, M.; et al. Health equity for persons with disabilities: a global scoping review on barriers and interventions in healthcare services. International Journal for Equity in Health, London, v. 22, n. 31, p. 1-17, 2023. DOI: https://doi.org/10.1186/s12939-023-02035-w
JIANG, Y.; et al. A universal interface for plug-and-play assembly of stretchable devices. Nature, London, v. 619, n. 7968, p. 78-84, 2023.
KEETHA, N. V.; et al. AnyLoc: Towards Universal Visual Place Recognition. IEEE Robotics and Automation Letters, New Jersey, v. 8, n. 2, p. 927-934, 2023. DOI: https://doi.org/10.1109/LRA.2023.3343602
MARTINS, L. O. M.; et al. Distributive justice and equity in resource allocation: a temporal analysis of hospitalization costs in indigenous populations in Brazil. International Journal for Equity in Health, London, v. 23, n. 5, p. 1-10, 2024. DOI: https://doi.org/10.1186/s12939-024-02102-w
MUKHERJEE, S.; et al. A High Power Density Wide Range DC–DC Converter for Universal Electric Vehicle Charging. IEEE Transactions on Power Electronics, New Jersey, v. 38, n. 7, p. 8012-8023, 2023. DOI: https://doi.org/10.1109/TPEL.2022.3217092
ROTHER, Edna Terezinha. Revisão sistemática x revisão narrativa. Acta Paulista de Enfermagem, São Paulo, v. 20, n. 2, p. v–vi, 2007. DOI: https://doi.org/10.1590/S0103-21002007000200001 DOI: https://doi.org/10.1590/S0103-21002007000200001
RUDIGER, A. The equity effect of universal health care. Health and Human Rights Journal, Boston, v. 25, n. 2, p. 75-84, 2023.
WANG, Z-Q.; et al. Pillararene-Based Supramolecular Polymers for Adsorption and Separation. Advanced Materials, Weinheim, v. 35, n. 3, p. 1-10, 2023.
