The United States is among the world’s wealthiest countries, and the biggest health care spender, by far — an average of about $11,000 per person annually. But it’s hard to argue that we’re getting our money’s worth. In the 2019 Bloomberg Healthiest Country Index, the U.S. ranked 35th. In a nation that devotes approximately 18% of its GDP to health care — other high-income countries average 11.5% — an estimated 27.5 million people in the U.S.

AS THE U.S. GRAPPLES with how to achieve universal access to quality primary health care, a Fielding School faculty member who has studied the experience of Brazil suggests there is much to be learned from Latin America’s largest country.

MUCH OF OUR WORK IN PUBLIC HEALTH is devoted to keeping people from getting sick through health promotion and disease prevention strategies. But all of us will, at some point, experience an illness or injury that requires medical attention or hospitalization. In addition, a key element of prevention involves regular visits to a health care provider for important vaccines and disease screenings, monitoring and counseling on risk factors, and keeping chronic conditions under control, to name only a few.