Government, health, doctors, press and middle class

I don't know why the Federal Government, led by a Labor president elected by the majority of the Brazilian people, becomes hostage to pressure exerted by the private business press and by professional categories or classes such as, for example, doctors, who categorically refuse to work in the interior of the country, to develop the deep Brazil that most Brazilians do not know and do not intend to know, since they obviously prefer to settle in cities and regions considered by them to be more pleasant and "civilized," as well as suitable to their economic, financial, and logistical interests.

This is the conduct and attitude of a large part of the medical profession. This happens because medicine has long since become a venal segment, strictly dedicated to commerce and consumption, dominated by the economic purposes of large international laboratories, private clinics and hospitals, as well as at the mercy of doctors and administrators who have become powerful entrepreneurs in the health sector, who even politically control the Federal Council of Medicine (CFM) and have strong influence regarding agreements and contracts signed with the SUS (Brazilian Public Health System), which sustains private hospital units, many of which do not provide the population with the proper return in terms of ensuring good care, in addition to not offering good quality medical and hospital services.

However, what strikes me most about the health crisis is the brazenness and perverse cynicism of the political and partisan opposition (PSDB, DEM, PPS and, regrettably, PSOL) of the Brazilian right, totally devoid of common sense while severely afflicted by Alzheimer's, as they are "incapacitated" for convenience in having a memory, and consequently, in remembering that they campaigned with the help of the market press against the CPMF (a tax on financial transactions), as well as voting against the contribution in the plenary sessions of Congress, which resulted in the loss of R$ 40 billion annually, money that financed public health, which urgently needs better health services to offer to Brazilian society.

All of this has been forgotten by right-wing politicians and parties, and by the mainstream foreign press, which is subservient to foreign interests and despises Brazil and the Brazilian people. This same colonized and historically coup-supporting press supported the "non-partisan" and "apolitical" way the middle class conducted itself and expressed itself, especially when its protests and "indignation" flooded the streets of Brazil after the Free Fare Movement (MPL), with its leftist agenda, was violently beaten by the São Paulo police, led by Governor Geraldo Alckmin, one of the national leaders of the PSDB, a party that calls itself social democratic but is actually a conservative, neoliberal party that, if it could, would sell what remains of this country's public assets, which, undoubtedly, were not built over time by the men and women of the PSDB.

I also consider it reckless and opportunistic of this same middle class, the legitimate heir of the march held before the 1964 coup, which cynically and mistakenly called the March of the Family with God and for Freedom, to hold protests only during the Confederations Cup, only to end their demonstrations immediately after its conclusion. Most of the people who watched the games were also members of this politically reactionary and socially prejudiced class, which, since the Industrial Revolution, has allied itself with the dominant oligarchies because it shares the same values ​​and principles as the privileged classes. These classes, among other things, tirelessly fight against the redistribution of income and wealth, and treat the issue of urban and rural land ownership as a police matter when the problem is fundamentally social. Unproductive large estates belong not to farmers, but simply to real estate agents, who occasionally wear boots and hats.

In turn, the middle class is always barred from the rich man's ball because, evidently, to their dismay and frustration, they have no money in their coffers, but only a few pennies in their pockets. Poor thing, so reactionary and perverse, yet so misguided and depoliticized. And behold, the lackeys and pitbulls serving the press barons turn against the arrival of foreign doctors in Brazil, "forget" about the end of the CPMF tax, and, not satisfied with that, constantly give a voice to the conservative doctors who control the Federal Council of Medicine and to the administrators and businessmen of health plans, who do not provide dignified care to the Brazilian people.

The truth is that this ideological and right-wing press manipulates information and refuses to democratize communications in Brazil. The private and hegemonic media system doesn't want anything to change, advance, or develop. This press wants everything to stay as it is because, I repeat, it is the spearhead of the establishment, which has guaranteed the status quo of the plantation owners throughout the centuries, who, if they were living in the 19th century, would undoubtedly be slave owners.

Suddenly, out of nowhere, doctors, residents, and even medical students mobilized, and, in unison, took to the streets to protest against the government's program. Hearing the voices of the demonstrators in June, the government began attempting to fulfill the (positive) demands of workers, students, and the opportunistic middle class, who mobilized to show their discontent with the rise of a segment of Brazilian citizens who gained access to durable goods, as well as frequenting airports, restaurants, and public universities that had previously been enclaves of the middle class, who received these services from public and political power as compensation for not owning the means of production.

Doctors and future healthcare professionals decided to show their true colors. Many of them behaved like true playboys, spoiled rich kids, whose egos put even Hollywood stars to shame. This is a complete contradiction and an arrogance and presumption comparable only to that of the representatives of the bourgeoisie, elected or not, who fight for their interests in all public forums, seeking to make the will and desires of those who occupy the top of the social pyramid prevail, who mistakenly consider the rise of the so-called C class a problem that could lead to a decrease in their bargaining power regarding privileges and favors.

The medical profession and medical students actually want to maintain their privileges, starting with fighting to prevent any change, as well as guaranteeing their market share in terms of jobs, even knowing that Brazil needs tens of thousands of doctors, since we have a population of 200 million inhabitants who are not adequately served because the medical demographics in this country are very poorly distributed, which leads to regional imbalances in the distribution and retention of health professionals. Furthermore, it is important to remember that the Brazilian state must significantly improve issues related to the financing and infrastructure of both the public and private health sectors; after all, the private sector must bear its responsibilities and not just worry about making a profit.

Data and figures released in February by the Ministry of Health show that Brazil has 1,83 doctors per thousand inhabitants. Period. The world average is 1,4 doctors per thousand inhabitants. The Ministry of Health projects providing the Brazilian population with 2,5 doctors per thousand inhabitants. England, for example, has 2,7 doctors per thousand inhabitants.

Therefore, the staff shortage is a serious issue and cannot be left to the political demagoguery of the right-wing opposition, the artificial controversies of the corporate press, which aim to create confusion to manipulate the population, in addition to the senseless and irresponsible corporatism of part of the medical class represented by the president of the CFM, Roberto Luiz d'Avila.

The spokesperson for the medical profession, I reiterate, does not want change. The Labour government intends to bring in foreign doctors to practice in remote locations and on the outskirts of cities. One of the reasons these areas lack doctors is because many of these healthcare professionals refuse to go to underserved areas, preferring to live in large and medium-sized cities for various reasons. That's a fact.

The Workers' Party government initially agreed not to require the revalidation of foreign doctors' diplomas. However, the Federal Council of Medicine (CFM) wants these doctors to take the Revalida exam, which could be accommodated. Furthermore, foreign doctors would sign temporary contracts of only three years, with salaries of R$ 10, and would only practice in remote or underserved areas. To achieve these goals, Brazil would need 168.424 more doctors, according to studies by the Ministry of Health.

Even so, the outcry is loud, and conservatives are taking advantage of it to create artificial crises in order to paralyze the actions of the Labor government, since there will be another presidential election in October 2014. The ruling class would die of disgust and bitterness if they go another four years without ascending the ramp of the Planalto Palace. Period.

However, the government wants to fulfill the positive agenda demanded in the protests, and everyone knows that the issue of health is on that agenda. However, judging by the way things are going, it seems the right-wing opposition and its mouthpiece—the press—are in no hurry. They create false controversy to bring the middle class, habitual consumers of their products, back to their political side. The manipulation and sabotage are well done and truly confuse the less politically aware and attentive.

Mediocrity reigns supreme in every corner of the earth. These obtuse people fail to see that social inclusion is the fuel for economic and financial development. The more people included, the more society will develop, in addition to reducing poverty and violence, because the dispossessed are generally the agents of everyday violence, so common in pockets of poverty, such as the favelas and peripheries of large and medium-sized cities. These bourgeois types take to the streets dressed in white, with aggressive, prejudiced, and disrespectful signs that would lead an unsuspecting citizen to think they were witnessing a parade of the Brazilian Integralist Action (AIB), a fascist movement led by Plínio Salgado. But we are in the 21st century – the beginning of the third millennium. Anauê!

Instantly, the bourgeois press set about creating yet another dispute, "fueling" another controversy, and, true to form, listened much more to one side than the other. And guess which side the mercantilist press listened to? The side of those who have more power, those who control and dominate the gigantic and billion-dollar markets of medicine and laboratories, who have as historical allies the Federal Council of Medicine, the powerful lobby of this sector in Congress, the numerous ministers who have occupied the position of Minister of Health, in addition to the commercial and private press (private in both senses, okay?), which operates in different media, and because of this is favored with multi-million dollar advertising contracts paid by laboratories, clinics, hospitals and health plans, which promote their brands and monopolize the market for medicines and medical and hospital care.

For this reason, and because of this, I consider it the height of absurdity to see these "rich kids" – still young and dressed in white – protesting without even discerning the realities of the facts. It's outrageous. These people don't know what's happening, or what forces are involved in this major issue that is Brazilian and, why not, global public and private healthcare. After all, the US president, Barack Obama, spent practically his entire term in constant struggle against the Republicans and the private press there to approve his government's project in favor of implementing a public and universal healthcare system that serves the American people. This is the truth: medicine has become merely an immeasurable business in the hands of unscrupulous businessmen and doctors.

However, Brazil has had its own healthcare system for some time now – the SUS – which is universal and sustains both public and private healthcare without the billions of dollars from the CPMF tax. This is because it transfers billions of dollars to the private sector, which, in return, offers a poor, sometimes extremely low-quality service, with enormous queues and recurrently dehumanized treatment. This generates conflict and complaints from those who pay for very expensive health plans that do not fully cover the needs of citizens, patients, and the sick, because there is a system of opportunism, a scam called "waiting period," that forces patients and consumers to wait to have the right to be treated.

However, first, the citizen needs to pray and cross their fingers, take a bath with coarse salt and then bless themselves so as not to die in the waiting rooms of the much-vaunted VIP healthcare system, which the middle class has always been keen to praise, something that is certainly not praiseworthy. The moral of the story: it's not only the SUS (Brazilian public healthcare system) that is the villain in these events. The private sector also has its share of villainy. But the press doesn't show it with the same emphasis as it does the public health sector. And why? I've said it before and I'll say it again: because it's the private healthcare sector that pays for advertising in the media, and these media outlets are the most important mouthpieces of the capitalist system.

Furthermore, the SUS (Unified Health System) is the system responsible for providing highly complex care to Brazilian patients and the sick. Believe it. This includes the citizen who reads and consumes tabloids of extremely poor editorial quality, such as Veja, O Globo, Estadão, Folha de S. Paulo, Correio Braziliense, and Zero Hora, not to mention radio and television stations like Globo News, TV Globo, TV Bandeirantes, CBN, and Jovem Pan, among many other media outlets that have been and continue to be politically, ideologically, and systematically opposed to the labor governments of Presidents Lula and Dilma Rousseff, as well as having the same conduct regarding the labor leaders Getúlio Vargas and João Goulart, in addition to Governor Leonel Brizola, the Brazilian politician who spent the longest time in exile. The governor from Rio Grande do Sul endured 15 years (1964-1979) of exile.

The Brazilian Unified Health System (SUS) needs funding. The problem with the Unified Health System is money. However, the SUS is an extremely important system for Brazil and Brazilians, because only the hospitals in the SUS network have equipment, medicines, administrators, and researchers that reflect the greatness of the SUS, which, according to the Federal Government and the sovereign will of the National Congress, will receive 30% of the pre-salt resources, as the other 70% will be allocated to education.

Advances in public health are visible, but the opposing propaganda is so systematic and forceful that it leads the population to be unaware of the virtues and work of the SUS (Brazilian Public Health System), especially regarding high-complexity care, expensive and state-of-the-art equipment, funding for patients' trips abroad, the promotion of research, the provision and distribution of medicines, and the funding of state and municipal programs, particularly for underprivileged communities, through the construction of Family Health Clinics and Emergency Care Units (UPA), where patients are monitored through computerized records, attended by the same doctor, which fosters a bond and trust between the patient and the doctor, in addition to appointments being scheduled by telephone.

Now, the question is: how do I know this? I could say I learned about it through information and news reports, which has already happened, as I've written some myself. That's true. But that's not it. I'm registered and have already been treated at the Family Clinic in the Botafogo neighborhood of Rio de Janeiro. I was very well treated, by the way. Therefore, I am a witness that everything in the SUS (Brazilian Public Health System) is not bad and incompetent, as the manipulative press, allied with imperialist governments and states, proclaims. The fundamentalist market media, which wants to dictate public life in order to govern in place of those elected by the Brazilian people, is an affront to the democratic rule of law.

In turn, the main hospitals, agencies, and advanced research institutions are linked to the public health system, including university hospitals. These institutions are incomparably more important and competent than the cartelized private healthcare system, which, undeniably, is also financed by the Brazilian state. When I see wealthy doctors refusing to go to rural areas and carrying signs like the one I saw a young woman displaying that read: "Dilma, go cure your lymphoma in the SUS (Brazilian public healthcare system)," I realized once again that our society, and specifically the globalized and computerized middle class, has lost its sense of what is human, what is a right, and what is reasonable.

What is this student thinking? Is she full of empty talk and malicious gossip? A selfish "rich girl" who doesn't know Brazil, much less its people, and who displays an inhumane, perverse, and infamous image. As a future doctor, she should at least have the sensitivity to understand that one doesn't joke about cancer, about the pain and suffering of others, especially when it's a complex disease that could become fatal. This "rich girl" will become a doctor. Perhaps she will become a cold, calculating, and therefore, irremediably heartless professional.

And so thousands of professionals graduate and carry out their activities in the same way, which leads me to say that the problem with the SUS (Brazilian Public Health System) and healthcare in general is not only financial and structural. There is a fundamental issue, which is respect for one's fellow human being, even if that "equal" is an authority figure like President Dilma Rousseff, who has obviously worked and strived to improve the living conditions of the Brazilian people. The public health budget in Brazil is gigantic, and the management of the system is complex because its administration takes place at the municipal, state, and federal levels. It's not easy.

It's easy, routine, and a constitutional right for a journalist to grab a microphone and carry a hidden camera, based on freedom of the press and expression. Showing the appalling conditions of a hospital is also easy. However, holding those responsible for ensuring medical and hospital care accountable is more difficult because, in addition to cases of corruption and the leniency and incompetence of administrators, public servants, and elected politicians, there is also the crucial issue of the business sector and the undeniable corporatism of the medical profession, undoubtedly exemplified by the president of the Federal Council of Medicine, who has irrefutably demonstrated that he does not want change, nor the entry of foreign doctors to serve the interior and the periphery, and is also against the government's project to have newly graduated doctors work for the national state for two years, even though most graduated from public universities and therefore not only should, but have an obligation to give back to society in the form of work, the society that financed their studies. Nothing beats experience and learning to become a good professional. If, after these two years, the doctor wants to go back to being a playboy, they are welcome to do so, as their paths are clear to make money.

In short: one of the establishment's heralds, the president of the CFM (Federal Council of Medicine), which also includes other segments of the health sector, wants everything to remain as it was before. However, the playboy doctors don't want to work in the interior of this vast country and categorically refuse to serve the people in the peripheries. They want, like in Rio de Janeiro, to work in the South Zone, the city center, and middle-class neighborhoods in the North Zone, such as Tijuca, Vila Isabel, and Grajaú.

Playboys want part-time public jobs, to work in private clinics or their own offices, and to skip shifts and even routine services whenever they want. What I'm saying is true and happens, as it also occurs in other professional sectors of the public service. Doctors have the right to earn money and use their profession merely as a tool for profit and dividends. A doctor can be cold, calculating, opportunistic, money-grubbing, selfish, apolitical, and display frivolous signs. A doctor can even commit crimes, like the fugitive Roger Abdelmassih and the plastic surgeon Hosmany Ramos. Abdelmassih was released by Supreme Court Justice Gilmar Mendes, who is known for granting habeas corpus to figures in the police chronicles.

Now, if a doctor doesn't want to work throughout Brazil even when he's still young, he doesn't have the right to prevent the labor government from seeking solutions to the problem and the dilemma. President Dilma and the Ministry of Health cannot be at the mercy of the interests of doctors linked to the capitalist system that controls the medical and laboratory sectors. A president is elected to solve the problems of the population and not to submit to the dictates of people, companies, and institutions that want to make medicine just a segment to make money. A lot of money, indeed. The rich are indeed a burden; but health is a right for everyone. Welcome to foreign doctors. That's it.