University of Guelph: English Language Certificate Program
Writing Level 8 Section 1
Instructor: Tan Ly
Name: Raquel Antunes

Brazilian x Canadian’s Public Health System

Health systems around the world can be delivered in different ways, being public, not-for-profit, or private. Within this context we have Brazil and Canada that offer to their population public health services to attend the citizens. These two are ones of the biggest countries in territory but the main difference is their population since Brazil’s number of habitants is nearly six times larger than Canada’s (200 million people versus 35 million people, respectively), this fact is significant when it comes to investments, resources, access, and public health policies. And with this we can see in those countries the differences between each other, not only in quality, but also in organization and health strategies. Public health services in Brazil are delivered by the Unified Health System and it is free to the entire population, but there is an imbalance between population’s access and investments in public health, because they have a significant number of citizens and different characteristics in the population, which generates a significant demand for the services. The public health system in Brazil operates all over the country following the same guidelines and is organized to prevent health problems in the first place or to be capable to solve them as soon as possible. In the Brazilian Unified Health System the main service offered to the population is the Family Health Program (PSF) which have teams working to take care of the population in each area of a neighborhood or city and they are composed of at least one doctor, one nurse, one nurse auxiliary, four to five community health workers (people who live in that area and can report problems and/or help to solve them), one dentist, one social assistant and one psychologist, and this team works to improve the living conditions and health in a general way, so is a simple way to deliver health services and depends on the demand of the population. (Paim, Travassos, Almeida, Bahia, &Macinko, 2011)
In Canada, the public health care is organized based on a law called Health Act, structured differently in each province, which makes the health services’ delivery vary from one region to another. This way, the provinces have their own organization related to investments, structure and funding, characterizing the Regional Health Authorities, which are the responsible for delivering services to the population’s health directly or indirectly (like contracting another health care service from another organization) and for managing the health services. In brief, we can state that the way Canadian Health system operates is articulated and independent, and according to Marchildon (2013), “The governance, organization and delivery of health services is highly decentralized for at least three reasons: provincial and territorial responsibility for the funding and delivery of most health care services; the status of physicians as independent contractors; and the existence of multiple organizations, from regional health authorities to privately governed hospitals, that operate at arm’s length from provincial governments”.
This is what this is what most distinguishes between both countries, while Brazil has a single way to deliver the public services to the population’s health, Canada shows a extremely diverse system in every province.
In the Canadian system, as it was said before, province has its own legislation about the single payment and the access to health services, which is known as "Medicare". Also provinces are the ones who stipulate how much medics will be paid (Marchildon, 2013). On the other hand, Brazil’s Unified Health System, as the name suggests, delivers the health services to the population within the same laws, only adjusting the delivery of some services depending on local characteristics, if