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Blog Sedes » Saúde: para quando ouvir doentes e contribuintes?

Abr 09 2009

Saúde: para quando ouvir doentes e contribuintes?

Publicado por Jose Almeida Serra a 8:23 em Artigos Gerais

O Sector da Saúde tem sido frequentemente palco de conflitos entre vários agentes, designadamente entre governantes e prestadores de cuidados de saúde ou governo e representantes das farmácias.

Desta vez assistimos a um conflito pouco comum: entre médicos (via seus representantes) e farmácias (idem), a pretexto de pretenderem estes últimos vender medicamentos genéricos em vez de medicamentos de marca.

Em todos os conflitos ocorridos – pelo menos tanto quanto me recordo – houve sempre grandes ausentes do debate: o doente e, em geral, o cidadão contribuinte (que no final paga a conta).

É evidente que ninguém pode substituir os médicos na prescrição, mas do componente activo (podendo até acontecer que apenas alguma(s) marca(s) responda(m) aos requisitos necessários). Mas se e quando houver no mercado medicamentos com exactamente a mesma composição, seria manifestamente abusivo impor uma marca mais cara à custa do contribuinte ou do doente. Como acontece com toda e qualquer marca: deve pagar quem a compra. Aliás não há aqui que inovar o que quer que seja; basta constatar o que, nesta matéria, ocorre em vários países muito mais avançado que o nosso em matéria de saúde e, em geral, de prestações públicas. A Ordem dos Médicos detém – até por Lei – determinadas competências e responsabilidades, sociais e públicas, sendo seu dever assegurar determinado nível de prestação pelo menor custo, tanto para o doente como para o contribuinte. E não pode desconhecer as competências de muitos profissionais de outras áreas, designadamente químicos, que vêm desenvolvendo investigação fundamental em matéria de fármacos.

As farmácias têm, em qualquer Sociedade, um papel importantíssimo em matéria de saúde, cabendo-lhes desenvolver toda uma relação de proximidade e de aconselhamento, para além de disponibilizarem os medicamentos aos doentes. É evidente que as farmácias são empresas, que vivem num e dum mercado, tendo de realizar lucros para sobreviver. Mas seria evidentemente inaceitável que viesse a ocorrer uma excessiva concentração de poder num grupo de farmácias ou de farmacêuticos, que possibilitasse a imposição de soluções (designadamente a realização de lucros anormais) que não tivessem adequadamente em conta os interesses dos utentes. Se pela via da produção de alguns genéricos se procurasse obter determinadas soluções de poder, estar-se-ia perante algo que não poderia ser aceite.

O Estado tem de ser independente de classes ou grupos. Será o Estado verdadeiramente independente quando, ano após ano, aceita que sejam as farmácias a “financiar” uma parcela muito importante do orçamento da saúde, já que não paga a tempo e horas?

Há quem afirme que a grande escassez de médicos que se verifica actualmente decorrerá de pressões e lobbies dos agentes de saúde. Mas, se tal aconteceu, não cabe uma parcela muito importante desta responsabilidade também ao Estado, que se demitiu das suas atribuições e responsabilidades?

Para o cidadão comum tem de ser claro que o Estado não é refém de grupos ou de lobbies e que se encontra em posição de dirimir adequadamente interesses que às vezes poderão ser conflituantes. Pelo que, nestas discussões a que vamos assistindo – entre Estado /Governo, médicos /prestadores de saúde e farmácias –, parece ser altura de envolver dois grupos que tradicionalmente não têm sido chamados à discussão: o dos doentes e o dos contribuintes.

Um comentário até agora


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Um comentário para “Saúde: para quando ouvir doentes e contribuintes?”

  1. Alberto Regueiraa 09 Abr 2009 as 11:35

    Caro Almeida Serra,
    Quero felicitá-lo pelo seu contributo de hoje. A matéria não podia ser mais importante e oportuna. Por coincidência, produzi ontem um artigo sobre o mesmo tema que deverá ver a luz do ciberespaço na próxima 5ª. feira, 16 (o meu artigo de hoje já estava antes em “backlog”). Como verá, há muitos pontos em comum, embora com diferenças de enfoque aqui e ali. Espero que até lá não perca actualidade.
    um abraço.
    Alberto Regueira


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