domingo, 27 de janeiro de 2013

WELFARE AND MEDICAL CARE


Since 1976, a time when the segment dedicated to health care was the responsibility of INAMPS, which became extinct in the late 1990's. Since then accompany the decline of Social Security, which was self-sufficient to pay for social security and health care quality provided to their insureds - had a right to health care who contribute to social security - an additional benefit in that contemplated immediate attention some cases of urgencies and emergencies. But this service was the prerogative of the citizen taxpayers Social Security at the time managed by INPS. To use the medical care provided by INPS enough to have that identification of brown paper with a photo of the user stamped and marked with their validity. This was achieved by presenting the CTPS that were stated in the employment contract in force, booklets contribution or settled GRs (Guides Collection) for other hypotheses, and documents such as birth certificates, wedding certificate reservist or equivalent. From there, if he had fulfilled grace period, could already make appointments and participate in other performances, both as to the social security health care.
An act of civic bravery of a president, not elected by popular vote, had a populist outburst when he said, "all Brazilians have the right to medical care." Passing the bill immediately to Social Security, which holds financial surpluses followed year after year, since the system was unified in 1967, incorporating several categories of welfare institutes, adopting a practice that had already occurred in IAPI, IAPC and IPASE, regarding other institutes categories economically less expressive joined to be supported by the same benefits and services.
After that saw the former INPS financially unable to honor both to health services, regarding social security benefits, which immediately ran the risk of becoming insufficient to cover Social Security - the main goal and because of the existence of the system .
Today, sadly, we see:
- SUS, as manager of health resources, with appropriations poorly distributed; own hospitals and other state maintained by agreement, most with inadequate facilities, lack of professionals (doctors and paramedics) who are paid hourly loads for extended demeaning to meet sick people in emergency rooms, clinics and hospitals where they perform procedures previously scheduled. It is common to see whether patients placed in hallways on stretchers and amazing, others thrown on the ground (some not even sporting a blanket).
- Health plans that came to occupy the space of the attention that was given to insured welfare, where migrated to sustain enterprises, whose ultimate goal is profit. These organizations charge high prices for a type of assistance only comparable to what was once taught by INPS after INAMPS, followed by no attention, since they were extinct. Contributions are heavy users and service providers are penalized for prices, often kept for long years without any adjustments or when granted, far from the true costs. Doctors, rightly, complained better wages, from the time that the social security surpluses had constant fundraising growing because the benefits of "immediacy" which was health care. Surely the medical profession had his reasons for claiming improvements, believing naively assume that the management system would be capable of improvement. That was a fallacy because they could not remove the causes of this crisis remuneration of their employment. There is also what some say about the use of cash resources in pension investments that have become repayable. That was an insult to the taxpayers of the pension purse, in this case, treated as if it were tax (VAT). In fact, the box was from the pension contributions that could never have been diverted to investment in public works, as were technical reserves for guaranteed future benefits to users of the system, therefore, contributed.
- As a consequence of these causes of widespread health care, without clear rules for obtaining resources, these same sources of the problem made the welfare practically unenforceable, causing flattening of the value of benefits (Aid Illness, Disability and Retirement Time Service, Help Birth, Solitude Aid, Salary and Allowance Family Permanency in Service). To continue these benefits became imperative to reduce the monetary values ​​and change in the interstices criteria for entitlement to their benefits. That, now, has caused widespread dissatisfaction and disinterest by policyholders, especially those whose membership was optional and others, even if required insured, which stopped contributing in part by limiting the amounts of pensions, whose range was limited to values ​​much smaller when there were retirements that came to be calculated based on contributions over twenty minimum wages or even the average wage gains effective. Individual taxpayers required, having no option to scale upward wage contribution, chose to contribute only on the value of a minimum wage, and many, not even that.
And so, the resources allocated to guarantee pension benefits of public pensions go against the growth of the population.
Conclusions and suggestions:
- History, which juts this study was initiated unification of security institutes in 1967, previously linked to several professional categories. One is that such unification purposes or without them, provided a progress in pension and health care. After this project of universal medicine swelled up crises made real in all segments: the welfare, public health and in the health system and insurance plans. The lack of conditions for belonging to this form of health elitist and difficult access, on the other hand, force the depreciation of medical work.
- Now, let's look at the state of public pensions, ie the general scheme. Some of the causes which made it impossible to continuity of care in the manner provided by INPS, also contributed to the dismantling of the public pension system. Aggravated today and in recent history has also been the welfare of the public official treated with the same allocation that should contribute to unfairly pay this bill. It is not uncommon to see more campaigns and campaigns, trying to blame the failure of the public employee pension plans. That same employee was recently conducted in the relegation your retirement, creating, by law, the public welfare as the ceiling guaranteed retirement for those who always contributed fully on total compensation at the rate (no tax) of 11%. For gains greater than this ceiling imposed by law, the server will have to contribute to a pension supplement called.
- Anyway, I understand, to the best judgment that the medical profession for some years now and suffers a wage tabelamento not conducive to the degree of academic and technical requirements. To prepare a physician for the market are taken six years at university, plus two to three years of residency to pursue a specialty, as many years to attend training courses and conferences systematically in order to update the knowledge. Improving wages involves the need to move, aimed through legislation creating tables able to grant them equality with other professionals of similar educational level.
- The financial balance of social security and health care, it seems to me that the possibility of the return to the origins of the model resulting from the unification of security institutes that occurred in 1967, observing the peculiarities present, is an important starting point. To attract contributors to social security, are required immediate and advantageous offers to be used as a form of attraction. The immediacy beneficial attracts the public taxpayer.

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