Only a great nation has something like our SUS (Brazilian Public Health System).

On a sweltering afternoon in Paraty, Rio de Janeiro, American journalist Terrence McCoy, from The Washington PostMcCoy saw his world spin after accidentally being hit on the head by the trunk door. Blood flowed, panic set in, but what came next was a revelation. Rushed to a public hospital, McCoy underwent an ambulance ride, CT scan, X-ray, received six stitches, and medication. The cost? Zero. “Nobody asked about my health insurance. Nobody asked for my social security number. Six hours later, the bill: $0,” he recounted, stunned, on social media. What would cost over R$50 in the US was, in Brazil, an unquestionable right.

This story is not an outlier. The Unified Health System (SUS), an achievement enshrined in the 1988 Constitution, is a constellation of hope for 215 million Brazilians and 2 million foreign residents. It illuminates every corner of the country, but we don't always recognize its brilliance. Having seen so many uninformed people with ulterior motives speak ill of the SUS, I will address here why the SUS is so important to Brazilian society, especially the millions who form the base of our social pyramid.

A reality that transforms - The Brazilian Unified Health System (SUS) is more than a health system; it's a tangible reality, firmly rooted in our collective imagination and in the Brazilian landscape, both urban and rural. Written in the 1988 Constitution, health as a universal right is an ideal that Brazil dared to realize. No other country with more than 100 million inhabitants has ventured to guarantee free healthcare to all, without distinction. "The SUS is the greatest revolution in Brazilian medicine," stated Congresswoman Jandira Feghali in a post on X, echoing the pride of those who see the system as a pillar of social justice.

But it's not all poetry. Decentralized management, which distributes resources between states and municipalities, sometimes stumbles due to misappropriation and mismanagement. "The big problem is that the money arrives, but it doesn't always go where it should," laments a user at the X clinic, reflecting the sentiment of many who recognize the greatness of the SUS (Brazilian Unified Health System), but suffer from its flaws. Overcrowding in hospitals, emergency care units, and primary health care units is a shadow that hangs over the system, but it doesn't extinguish its light.

Stories that cross borders - It wasn't just McCoy who was surprised. In 2025, an American woman from Texas, Bri, shared her experience with the Brazilian public healthcare system (SUS) in a post on X. Seen in just 20 minutes, without paying anything, she wrote: “I was shocked! In Texas, this would never happen.” Her story resonated, a reminder that the SUS not only heals, but connects worlds.

In Ceará, another case. An American nurse, taken by a Brazilian colleague to the Leonardo da Vinci State Hospital, was speechless. "It's more modern than many hospitals in the US," he said, impressed by the technology and infrastructure acquired in 2020 by the state government. A reference in complex surgeries, the hospital is an example of the potential of the SUS (Brazilian public healthcare system) when well managed. These foreign voices echo what many Brazilians feel: pride mixed with frustration, hope intertwined with challenges.

And then there are the inside stories. A Brazilian, recently operated on for appendicitis, wrote on X: “I saw humble people receiving dignified treatment. If it weren't for the SUS [Brazilian public healthcare system], only God would have helped.” Another celebrated the complex surgeries that saved his brother, all free of charge. “We have to raise our hands to the heavens for this country,” he exclaimed. These stories are threads in a larger fabric, woven by a system that, even imperfect, doesn't give up on anyone.

A past without support - Before the SUS (Unified Health System), public health in Brazil was a very colorful, fragmented picture, a void where millions were left helpless. Until 1988, the system was centered on the National Institute of Medical Assistance of Social Security (INAMPS), which only served workers with formal employment contracts, leaving 80% of the population without coverage. Public hospitals were scarce, and health was a privilege, not a right. Diseases such as measles and polio were rampant, and infant mortality reached 85 per thousand live births in 1980, according to the IBGE (Brazilian Institute of Geography and Statistics). The SUS changed this, reducing the rate to 12 per thousand in 2023, a leap that reflects its ability to transform lives.

The engine that drives the nation - The Brazilian Unified Health System (SUS) is a colossal machine. Present in 5.570 municipalities, it covers 100% of the Brazilian territory with 43 Basic Health Units (UBS) and 1,2 Emergency Care Units (UPA). It offers everything from preventive consultations to organ transplants, including vaccinations, childbirth, highly complex surgeries, and cancer treatments. More than 26.900 doctors work through the Mais Médicos program, while the Farmácia Popular program benefits 24 million people with free medication.

The numbers are impressive. In 2024, the Federal Government allocated R$ 170 billion to the SUS (Unified Health System), a 20% increase compared to 2020, when the budget was R$ 141 billion. These resources support 3,7 million formal jobs and serve 75% of the Brazilian population, which depends exclusively on the public system. It is a herculean effort, but insufficient to eliminate waiting lists and improve management in some regions.

Vaccination is one of the triumphs of the Brazilian Unified Health System (SUS). In 2024, Brazil was removed from the list of the 20 countries with the most unvaccinated children in the world, thanks to robust campaigns. The transplant program, a world reference, performed more than 8.000 procedures in 2023. And the SAMU (Mobile Emergency Care Service), with its ambulances crisscrossing the country, saved countless lives in emergencies. The SUS is a giant that never sleeps.

Countries send experts to learn about our SUS (Brazilian public healthcare system). Brazil's SUS is unique, but how does it compare to other systems? In the US, healthcare is a market, not a right. In 2023, 27 million Americans lacked health insurance, according to the US Census Bureau, and a basic consultation can cost $200. The Affordable Care Act (Obamacare) expanded access, but did not universalize care. Public hospitals are rare, and emergencies, like McCoy's, generate exorbitant bills. The SUS, even with waiting lists, guarantees unrestricted access, something unthinkable in the US.

In Chile, the public system, called FONASA, covers 80% of the population, according to the Chilean Ministry of Health, but faces similar challenges to the Brazilian SUS: waiting lists and underfunding. In 2024, Chile invested US$12 billion in public health, proportionally less than the R$170 billion invested by the SUS for a population 10 times smaller. While the SUS offers transplants and high-complexity care free of charge, in Chile, co-payments are common, limiting access for the poorest. The SUS, with its flaws, is still a model of inclusion.

Other countries are following Brazil's example. The United Kingdom's National Health Service (NHS), created in 1948, is a close relative, offering free universal healthcare. South Africa, with its plan... National Health Insurance (NHI) seeks to replicate the Brazilian model, aiming for universal coverage by 2030. Cuba, with its public health system, also echoes the SUS, prioritizing prevention and unrestricted access. These countries see health as a right, not a privilege, but Brazil stands out for the continental scale of its operation. It's no coincidence that we frequently have delegations of public health experts visiting the country to learn more about our Unified Health System. We have more than just beautiful cities, football, carnival, and samba. Much more.

In the eyes of the world - The Brazilian Unified Health System (SUS) is a mirror of the Brazilian soul: generous, resilient, but marked by contradictions. It saves lives, like McCoy's, Bri's, and so many others, but groans under the weight of mismanagement and corruption. "The SUS is wonderful, but sometimes I spend the whole day waiting for treatment," laments a user at the X clinic, capturing the duality of a system that is both a miracle and a challenge.

We, Brazilians, have the task of protecting this heritage. Strengthening the SUS (Brazilian Public Health System) requires more than resources; it demands vigilance, efficient management, and a collective commitment. It is the heart that pulses life in our veins, a system that welcomes the foreigner, supports the humble, and challenges the logic of a world where health is a commodity. The SUS is ours, and it is up to us to make it beat stronger.

In 2025, with global events like COP 30 and the BRICS Summit on the horizon, Brazil will be under the world's scrutiny. May the SUS (Brazilian Public Health System) be not only our achievement, but our showcase, a reminder that, even amidst storms, we are capable of building something that inspires. Let's take care of it. Let's get to know the SUS, this giant that, even with some imperfections, continues to save lives and teach us what it means to be human.