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Cash-strapped Rio de Janeiro Hospitals Turn Away Patients, Shut Doors, Prompting Healthcare Crisis in Brazilian City

State governor declares ‘state of emergency’ and asks central government for aid to get healthcare facilities reopened in city that will host 2016 Summer Olympics

As U.S. healthcare officials look to contain the spiraling cost of care in this country, government leaders in Brazil are facing an unprecedented healthcare crisis that has caused cash-strapped public hospitals in Rio de Janeiro to close their doors or limit services due to lack of funds.

No News Coverage about Brazil’s Medical Laboratories

Clinical laboratory executives and pathologists should take note of this unfolding story. It may be without precedent that public hospitals in the capital city of one of the world’s faster-growing economies have had to cease medical services because there is no money to pay physicians and staff and buy the necessary medical supplies.

Luiz Fernando Pezão, the current State Governor of Rio de Janeiro, on Dec. 23, 2015, declared a “state of emergency” after as many as 15 outpatient clinics closed and hospitals began limiting their admissions to those with life-threatening conditions.

“Rio’s hospitals are in a catastrophic situation. We don’t have anything to work with,” Barbara Bastos, a 30-year-old surgical resident, told the Agence France-Presse (AFP) news agency in an article published on Yahoo! News. “We’ve already had to cancel operations, some pharmacies and emergency rooms have closed, and all that when we have patients in serious condition.”

The International Business Times reported that a woman in the municipality of Mesquita gave birth on the sidewalk outside a hospital because it could not afford to admit her.

Brazil’s Constitution Says Healthcare Is a Right

Brazil’s 1988 constitution declared healthcare to be the right of every citizen. Funding for the country’s national healthcare system is split among federal, state, and municipal governments. Despite the federal mandate and the availability of free care through Brazil’s Sistema Único de Saúde or Unified Health System, consulting firm Deloitte says about one-fourth of the country’s 202 million population is enrolled in private healthcare plans. They opted for U.S.-style healthcare insurance that pays for care in private healthcare facilities instead of relying on the national healthcare system.

No News about Budgets for Clinical Laboratories in These Hospitals

Governor Pezão’s decree immediately provided Rio de Janeiro with $25.3 million in federal aid that will be used to pay doctors and other staff (some of whom reportedly had not been paid in four months), as well as cover the cost of key medical supplies. Online news website Inquisitr estimated the state’s healthcare debt at roughly $355 million, including what it owes suppliers and healthcare workers.

“We are living through a very difficult situation in the state, perhaps the most difficult of any of the Brazilian states,” declared Pezão in an Examiner story. “But we are counting on the federal government, President Dilma Rousseff, and everyone else to pull the state out of this situation as quickly as possible.”

In addition to the influx of money, the central government also donated equipment and surgical items ranging from tape and gloves to orthopedic prostheses, catheters, and drugs to the state’s underfunded hospitals, The Rio Times reported.

“This partnership with the federal government and the City Hall is essential. The state has no money machine. We depend on these transfers, especially given the severity of the financial crisis in the country, which has serious consequences for our state,” Pezão told The Rio Times. Pezão estimated that the state hospital system would resume functioning by the end of December. Until then, 1,500 beds were made available in federal government hospitals to patients that would normally be admitted to the state system, The Rio Times reported.

Governor Luiz Fernando Pezão (left) announced the state of emergency in Brazil following a meeting with Alberto Beltrame (right), the federal Minister of Health. Pezão declared the state of emergency after many of the state’s hospitals and clinics closed their doors or limited services because they could no longer afford to pay staff or purchase equipment and supplies. (Photo copyright: The Rio Times/Fernando Frazão/Agência Brasil.)

Governor Luiz Fernando Pezão (left) announced the state of emergency in Brazil following a meeting with Alberto Beltrame (right), the federal Minister of Health. Pezão declared the state of emergency after many of the state’s hospitals and clinics closed their doors or limited services because they could no longer afford to pay staff or purchase equipment and supplies. (Photo copyright: The Rio Times/Fernando Frazão/Agência Brasil.)

Summer Olympic Games to Follow Cessation of State of Emergency

According to The Examiner, the state of emergency in Rio de Janeiro will remain in place into late June—40 days before the start of the Summer Olympic Games. The recession-plagued South American country has been particularly hard hit financially because it relies heavily on oil revenue and the recent drop in crude prices exacerbated its budget crisis.

Rio Regional Council of Medicine President Pablo Vazquez questioned whether the healthcare system is prepared to handle the influx of visitors expected for the Olympic Games.

“We the doctors are worried—we don’t know if we’ll be in a position to care for our population, let alone for the tourists,” Vazquez told the AFP.

However, Health Minister Marcelo Castro told the AFP “six federal hospitals without financial problems will ‘be at the disposition of the state of Rio’ and that doctors and supplies will be transferred to hospitals in need.”

Few Medical Laboratory Professionals in the U.S. Know of These Problems

This crisis in healthcare in Brazil received little media coverage in the United States. That is why few pathologists and medical laboratory professionals in this country were aware that public hospitals in Rio de Janeiro state had run out of money and had stopped accepting patients. What makes this story worth understanding is that it is an early example of the crisis that results when increased demand for healthcare services outstrips the capability of a government health system to fund the level of care needed.

In the case of Brazil, a substantial decline in revenue from oil production is the reason why the government lacked adequate funds to pay for healthcare in the government health program. Meanwhile, the private healthcare system in Rio de Janeiro state seems to be functioning with no problems. This dichotomy of access to care in a country which has defined healthcare as a constitutional right will probably play a role in how to fund healthcare for all the population of Brazil in the years to come.

—Andrea Downing Peck

Related Information:

Healthcare System in State of Emergency in Rio de Janeiro

Rio Governor Declares Health Sector Emergency Ahead of Olympics

Brazil’s Financial Health is Troubling for Country’s Medical Healthcare Systems

Rio de Janeiro Announces Health Emergency & Corruption Probe Just Months Away from Olympics

Brazil: Rio de Janeiro Declares Health Sector Emergency Amid Budget Woes

Rio de Janeiro’s Governor Declared Emergency State in City’s Health System

Rio de Janeiro Declares Health System Emergency as Olympics Loom

2015 Health Care Outlook Brazil

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