Regardless of the level of health financing, inefficient use of resources is seen as contributing to weak health systems around the world. The criticism here revolves around the high fragmentation of the sector, lack of coordination in the provision of services and undue focus on hospital and specialized care. There is a growing demand to reorganize health systems to provide people-centered services, requiring a model of multidisciplinary and integrated work care. The pressure for a greater focus on preventive health services to contain noncommunicable diseases and primary health care is not new, but it recovered its momentum in the second decade of this century. Primary care is seen as an effective strategy to face organizational inefficiencies and contain costs through better coordination of outpatient clinics with hospital services, preventive care with curative care and health services with social assistance to meet the needs of the aging population.
Many system reforms focused on cost containment and greater competition for better cost efficiency. These reforms resulted in an increasing diversification in the forms of service provision without reorganizing the system.
We need to change the national debate only on health care financing to build the best care delivery system to promote access for users, greater value and better health for the population.
It is necessary to strengthen primary care, and this must be a firmly established political goal for the sustainability of the system.