Abstract
The debate on the supply and organization of specialized outpatient care at the Brazilian Unified National Health System (SUS) and the need to reduce waiting times for access to comprehensive and quality care has become one of the most important agendas for SUS managers and researchers in Health Policy, Planning, Management, and Evaluation and various civil society segments. This theme shows a gap in its theoretical, normative, and fundamental formulation to consolidate SUS as a comprehensive system with universal access. Some recent advances to face this serious problem have been implemented, such as the Brazilian National Policy for Specialized Health Care, of the Brazilian Ministry of Health, and the successful experiences of some state and municipal administrations. This essay was based on the theoretical reflections and experiences of its authors as SUS managers. It offers four reflections on the challenges to waiting lists. the first of which seeks to critically analyze whether long waiting lines really constitute the main problem for access to the SUS specialized outpatient care. This study then discusses the challenges to monitoring waiting times for specialized outpatient care access. The third point indicates and analyzes regulatory devices that have managed waiting lists, focusing on the needs of users. Finally, the fourth reflection addresses the need to produce and ensure transparency in the waiting lists for managers, workers, and users.