(Oct. 30, 2013) On October 22, 2013, Brazilian President Dilma Roussef signed Law No. 12,871 (Lei No. 12.871, de 22 de Outubro de 2013, PLANATO.GOV.BR), which creates the More Medical Doctors Program. This program enables the hiring of Brazilian and foreign medical doctors to work in the National Health System (Sistema Unico de Saúde – SUS) in medically underserved areas, such as in the outskirts of large cities and municipalities and in isolated regions. (‘Não É Coragem, É Dever,, Diz Dilma ao Sancionar Lei do Mais Médicos, O DIA (Oct. 22, 2013).)
According to article 1 of Law No. 12,871, the purposes of the Program are to:
- develop human resources in the medical field for the SUS and decrease the shortage of medical doctors in priority regions for the SUS, in order to reduce regional inequalities in health;
- strengthen the provision of primary health care services in the country;
- improve medical education in the country and provide doctors with more medical experience in the field during the training process;
- enlarge the amount of medical training at the clinics of the SUS by developing their knowledge of the actual health situation of the Brazilian population;
- strengthen the policy of continuing education, through the integration of teaching and provision of services;
- promote the exchange of knowledge and experience between Brazilian health professionals and foreign-trained physicians;
- enhance medical expertise in the area of public health policy and in the organization and functioning of the SUS; and
- encourage the development of research applied to the SUS. (Lei 12.871)
To achieve Program goals the following steps will be taken:
- the locations of medical courses and places for residency will be reorganized and priority will be given to regions with the lowest ratio of vacancies and physicians per capita that also have a structure of health services that can offer sufficient and quality field practice for medical students (id. art. 2(I));
- new standards will be set for medical training in the country (id. art. 2(II)); and
- in SUS priority regions, improvement of the skills of primary health care doctors will be promoted through integration of teaching and provision of services, including by means of international exchanges (id. art. 2(III)).
Law No. 12,871 also establishes within the More Medical Doctors Program the Project More Doctors for Brazil, which will be offered to physicians trained in Brazilian institutions of higher education or who possess a diploma revalidated in the country and to medical doctors trained in foreign institutions of higher education through international medical exchanges. First priority for this Project will be given to doctors trained in Brazilian institutions of higher education or who possess a diploma revalidated in the country, including retirees. Second priority will go to Brazilian doctors trained abroad, and last priority will be assigned to foreign doctors trained abroad (id. art. 13).
Law No. 12,871 is regulated by Decree No. 8,126 of October 22, 2013. (Decreto No. 8.126, de 22 de Outubro de 2013, PLANATO.GOV.BR.)
Background Information on the SUS
The SUS was created by the Constitution of 1988 (Constituição da República Federativa do Brasil de 1988, arts. 196 et seq., PLANATO.GOV.BR) for the purpose of changing the situation of inequality in the health care of the population by making the medical treatment of all citizens by public institutions mandatory. SUS prohibits the charging of money under any pretext. The system is regulated by Laws No. 8,080 of September 19, 1990 (Lei No. 8.080, de 19 de Setembro de 1990) and 8,142 of December 28, 1990 (Lei No. 8.142, de 28 de Dezembro de 1990).
Health centers, health posts, hospitals (including university hospitals), laboratories, blood banks, foundations, and research institutes are all included in the SUS. Through the SUS, all citizens are entitled to appointments, exams, hospitalizations, and treatments in municipal, state, and federal health units that are connected to the SUS by contracts concluded by the Director of Public Health, whether those units are public or private (Sistema Unico de Saúde, PORTAL DA SAÚDE (last visited Oct. 28, 2013.)
The SUS is intended for all citizens and is financed with funds raised through taxes and social contributions paid by the population and that comprise the resources of the federal state and municipal governments. The private sector participates in the SUS in a complementary way, through contracts and agreements for the provision of services to the state where the public health units are not sufficient to ensure service to the entire population of a given region. (Id.)