eee2p.gif (2459 bytes) Economia & Energia
No 18 January-March 2000
setae.gif (960 bytes)English Version

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Sarah Network and Healthcare

Carlos Feu Alvim
English Version: Frida Eidelman

Since we are used to generalized and acid criticism to Brazilian institutions, any positive emphasis placed on them seems official or officious propaganda (generally it is so). A compliment to the way Dr. Campos da Paz administers the Sarah Network does not run this risk since he defends a medicine that does not conform to the present standards and in some way goes against the liberalism dominant in our peripheral countries.

The Sarah Network Letter No 1 of November 1999 describes an original and modern concept of public administration and calls attention to the dangerous conflict of interests allowed by the 1988 Constitution which renders our public healthcare so expensive and inefficient.

The Network's Head-Surgeon had previously exposed his ideas in several occasions, especially in an interview to VEJA magazine some years ago and in a recent article published by O GLOBO and CORREIO BRAZILIENSE. In the Sarah Network Letter and in the site he describes the merits of the "management contract" model which, using exclusively public resources and practicing an " equitable and free" medicine, obtains extremely high satisfactory levels.

Dr. Campos da Paz is known for his capacity of swimming against the tide and favoring public healthcare in the institutions under his management. I don't know him personally but I know that in this combat he made precious friends who are near to the power centers and some enemies of his methods, considered as authoritarian by many.

Brazilians have a certain rejection for winners and they look for faults in those who are prominent. Furthermore, there is a Brazilian phenomenon that the former minister and present Brazilian ambassador to UNESCO denominates " underdevelopment self-consistency" which tends to perpetuate itself eliminating the positive points.

Dr. Campos da Paz has defeated this trend and has consolidated his system from the institutional point of view. He accomplished to transplant a model that worked in a hospital to a network of hospitals and presents arguments for extending it to the public network.

Working with positive examples (and viable under boundary conditions different from the original ones) is a technique little explored in Brazil. In the case of public administration, there is still the risk for the good examples to be contaminated by pro or anti political exploitation.

Network Sarah is an interesting example because it does neither give rise to enthusiasm in the right-wing liberalism (it restores the credibility of public institution) nor the left-wing collectivism (personnel policy considered as authoritarian).

I know other examples of this kind of "third way" in treating public matters. I will mention two relatively recent ones. The first one is the Navy nuclear program formulated and conducted during a good period by Admiral Othon, where technological mastering and uranium enrichment are only the visible results. The other one is one director - I could not retrieve his name - who transformed the Post Office, using serious administrative processes, into an institution that Brazilians considered to be the most trustful in the start of the nineties, according to a national poll that included Brazilian private, governmental and social institutions (including the Church ).

We took the liberty of reproducing in e&e some articles of "Sarah Network Letter". The subject addressed is not alien to our theme economy, since healthcare is becoming a relevant economic sector. The true reason for referring to the subject is that reading its content gave me - in this turn of century - some reason to solidify my hopes on Brazil in the midst of so many crises. I wanted to share this feeling with our readers.