Let the Cubans come.
The outcry is great because Brazil is witnessing the breaking of a monopoly in public health.
Doctors, professional associations, and the Federal Council of Medicine (CFM) itself are outraged. They have offered all sorts of opposition to the Mais Médicos program and have now been surprised again by the news that the federal government will bring in four thousand professionals trained in Cuba, who will work in 701 municipalities. With this importation, Brazilian citizens from remote areas who have never seen a doctor – and who would never see one, if it depended on medical corporatism – will be able to extend their life expectancy, being diagnosed and monitored in the treatment of controllable pathologies, such as simple hypertension.
If the program is effectively implemented, Brazil could move towards having, in the medium term, a life expectancy similar to that of Cuba. Yes, Cubans live longer: 79,3 years, a standard similar to that of some European countries and well above the Brazilian average, which is still 73,8 years. There, one of the factors that explains the success is the high investment in health – 9,7% of GDP, compared to 4,2% in Brazil. Another is the widespread adoption of family health programs.
According to a statement from the Federal Council of Medicine, the decision announced last week is "electioneering" and puts the population's health at risk. But what is worse? To be treated by Cuban professionals or to continue without any assistance at all? It is worth noting that the 701 municipalities that will receive the Cuban doctors did not attract the interest of any Brazilian professionals, who had priority in the registration for the Mais Médicos program.
In practice, what Brazil is witnessing today is the breaking of a monopoly – and that is why the outcry is so loud. Professional associations are interested in regulating the supply of professionals in the market and thus preserving a situation that generates high incomes for scarce professionals. Indeed, precisely because they are in high demand in large urban centers, where life is more pleasant than in the peripheries and remote areas, Brazilian doctors disregarded the vast majority of scholarships offered by the Mais Médicos program.
Conservative critics will argue that healthcare is a different case and cannot be treated like a commodity or any other activity. However, the Cuban experience has already been implemented in several countries – and it has been successful. In Portugal, for example, the population approves of the professionals' work.
According to a statement from the Ministry of Health, the doctors coming to the country have, on average, 15 years of experience. They will certainly contribute to results that, in the future, will make the current criticism be remembered only as a corporate outcry against the end of a monopoly.