Health reform in Brazil: lessons to consider

US analysts and decisionmakers interested in comparative health policy typically turn to European perspectives, but Brazil-notwithstanding its far smaller gross domestic product and lower per capita health expenditures and technological investments-offers an example with surprising relevance to the US health policy context. Not only is Brazil comparable to the United States in size, racial/ethnic and geographic diversity, federal system of government, and problems of social inequality. Within the health system the incremental nature of reforms, the large role of the private sector, the multitiered patchwork of coverage, and the historically large population excluded from health insurance coverage resonate with health policy challenges and developments in the United States.