“Competence in SUS”: Response from the authors of “SUS: The Controversy Over Competence” – 01/13/2023 – Saúde em Publico

On December 26, 2022, the blog Saúde em Público, from Folha de São Paulo, posted, Article By Ricardo de Oliveira, with comments on our book, “SUS debate about efficiency”published this year by Editora Fiocruz.

Complementary considerations notwithstanding—for which we are expressly grateful—the article is wrong and misrepresents its purpose.

Since the debate about competency in the Unified Health System (SUS) is of general relevance and can help formulate, implement and evaluate health policies, we would like to offer the following illustration to the readers of this prestigious journal.

One of the main hypotheses of our book is that in some cases efficiency in SUS is impaired by underfunding in the system. This is very different from saying that shortcomings ultimately cannot or should not be assessed, measured and overcome.

Thus, we were surprised by the consideration attributed to us “(…) that the lack of funding does not allow an assessment of the efficiency of the application of resources in the SUS”.

He never said this: on the contrary, in the presentation of the book itself, we mentioned “our interest in examining competency in SUS”.

It should be noted that we have already produced several works on competency assessment in SUS and in other health systems, including national and international scientific books and journals. So it would be pointless to write a book about A.S warm Title In the public policy agenda, if we think it will not be possible to evaluate the efficiency of application of resources in SUS.

We are open to the practice of criticism and self-criticism, however, at that moment it seemed important to us to make clear our interest in assessing the efficiency of the Brazilian health system, as well as to contribute to the technical and scientific development of this method without abandoning the constitutional assumption that health is a social right in our country.

Alexandre Marinho is an economist, holds a PhD from Fundação Getulio Vargas Graduate School of Economics (EPGE-FGV), planning and research technician at the Institute for Applied Economic Research (Ipea) and associate professor at Rio de Janeiro State University (UERJ). Carlos Octávio Ocké-Reis is an economist and holds a PhD from the Hesio Cordeiro Institute of Social Medicine (IMS-UERJ). Planning and research technician at the Institute of Applied Economic Research (Ipea).

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