Does Health Begin at the Hospital or Much Earlier? 2026 Elections President

When someone searches for the government plan of a presidential candidate in Brazil's 2026 Elections, Health usually means very concrete questions.

How long will I wait for an appointment?

Will I be able to get my test?

Will there be a specialist available?

Will the medication be accessible?

Will the SUS be able to perform my surgery?

Will mental health receive proper attention?

Can technology help reduce waiting lists?

These are fundamental questions.

But Body-Territory adds another one:

What happened before this body needed to reach the hospital?

Water, food, housing, violence, work, income, climate, sanitation, mobility, territory, and social relationships also participate in the conditions that produce health and illness.

This article does not rank candidates, recommend a vote, or determine which plan is better. The summaries below present proposals found in government plans and public sources. The discussion of Body-Territory, Decolonial Neuroscience, and SUS VIP is a BrainLatam proposal and does not belong to any candidate unless explicitly stated.

What do the presidential candidates propose for Health in the 2026 Elections?

Luiz Inacio Lula da Silva, presidential candidate for PT

Lula proposes strengthening the SUS, expanding vaccination, digitalization, and existing policies that improve access to physicians, medicines, and specialists. A health policy document that supports his broader program also proposes strengthening Primary Care, the Family Health Strategy, telehealth, river-based healthcare teams, access to drinking water and sanitation, and better connection between Indigenous territories and traditional communities and specialized healthcare networks.

Our expansion: this relationship between health and territory could advance further by treating water, sanitation, food, climate, and social conditions as part of the preventive infrastructure of the SUS itself.

Flavio Bolsonaro, presidential candidate for PL

Flavio Bolsonaro proposes telehealth, home care, national vaccine production, adjustments to the SUS reimbursement table, and greater interoperability between the public system and private healthcare networks.

Our expansion: integrating networks can increase healthcare capacity. Body-Territory would add criteria to verify whether that capacity actually reaches the places where access is most difficult.

Romeu Zema, presidential candidate for Novo

Romeu Zema proposes greater integration between the SUS and private healthcare providers, within a broader approach of reducing direct State participation and using available private-sector capacity.

Our expansion: the availability of a medical procedure does not necessarily mean real access. Distance, transportation, income, and the ability to leave work temporarily also determine whether someone can reach treatment.

Ronaldo Caiado, presidential candidate for PSD

Ronaldo Caiado proposes reducing SUS waiting lists, prioritizing patients by severity, expanding prevention, digitalizing medical records, using artificial intelligence, strengthening prenatal care, psychological healthcare, vaccination, and national efficiency indicators.

Our expansion: in addition to classifying the risk of those already on a waiting list, it may be possible to identify territories accumulating risk before residents need to enter that list.

Renan Santos, presidential candidate for Missao

Renan Santos proposes reorganizing SUS waiting lists according to clinical risk, within a broader reform of public administration.

Our expansion: Body-Territory would distinguish between two types of risk: current clinical risk and territorial vulnerability that increases the probability of future illness.

Augusto Cury, presidential candidate for Avante

Augusto Cury places preventive medicine, emotional health, and socio-emotional education among the central elements of his program.

Our expansion: emotional health does not depend only on an individual's ability to manage feelings. Violence, unemployment, food insecurity, exhausting work schedules, isolation, and territory also participate in emotional experience.

Clariana Barao, presidential candidate for DC

Clariana Barao proposes integrating healthcare with artificial intelligence and telemedicine, alongside public management guided by goals and evidence.

Our expansion: the same evidence does not necessarily require the same intervention in an Indigenous village, a riverine community, an urban periphery, or a major metropolitan center. Evidence also needs to meet territory.

Edmilson Costa, presidential candidate for PCB

Edmilson Costa proposes nationalizing healthcare within a broader socialist transformation of the economy and public services.

Our expansion: regardless of whether a provider is public or private, Body-Territory asks whether the system can understand the conditions producing illness before the patient arrives.

Hertz Dias, presidential candidate for PSTU

Hertz Dias places healthcare within a socialist program of expanding public services and structurally transforming the State. Among the specific proposals mentioned in his program is the legalization of abortion within the SUS.

Our expansion: health decisions do not happen separately from income, culture, religion, family relationships, violence, access, and territory. It is precisely at this intersection between perception, politics, science, and culture that we situate Decolonial Neuroscience.

Rui Costa Pimenta, presidential candidate for PCO

Rui Costa Pimenta proposes full nationalization of healthcare, alongside other major transformations in the economic and institutional structure.

Our expansion: a fully public system would still need to answer why some territories produce much more illness than others.

Samara Martins, presidential candidate for Unidade Popular

Samara Martins is a dental surgeon and works within the SUS through the Family Health Strategy. Unidade Popular published an expanded version of its program after the first brief version registered with the TSE, later adding a specific healthcare section as part of its defense of expanded rights and public services.

Our expansion: the Family Health Strategy itself offers an important bridge to Body-Territory because it brings the State closer to everyday life, families, and communities.

Wilson Grassi, presidential candidate for Democrata

Wilson Grassi proposes what he calls One Health, integrating human and animal health into the SUS.

The proposal is aligned with the international One Health concept, which recognizes the interdependence of human, animal, plant, and ecosystem health.

Our expansion: Body-Territory would add culture, social relationships, history, economic conditions, and perception to this integration.

Pablo Marcal, presidential candidate for PRTB

As of the consultation published on August 18, Pablo Marcal had filed his candidacy registration, but the PRTB had not yet submitted a government plan on the official TSE platform. For this reason, we do not attribute a specific healthcare proposal to him.

Health does not begin when disease appears

The SUS already emerges legally from a broader understanding of health.

The Brazilian Constitution establishes health as a right of all and a duty of the State and connects this right to social and economic policies capable of reducing risks.

Therefore, Body-Territory does not need to deny the SUS in order to expand it.

It can deepen something that already exists within its principles.

A body drinks water produced outside itself.

It breathes air produced outside itself.

It eats food that depends on soil, climate, logistics, and income.

Sleep depends on territory.

Mobility depends on territory.

Exposure to violence depends on relationships.

Occupational illness depends on how work is organized.

The body has biological boundaries, but the conditions that maintain its functioning go beyond the skin.

Latin American Collective Health already thinks in this direction

Latin America has developed its own tradition of thinking about health.

In 2024, Gil Sevalho, from Fiocruz, revisited contributions from Brazilian scholar Naomar de Almeida Filho and Ecuadorian epidemiologist Jaime Breilh to discuss the social determination of health, complexity, and coloniality.

This tradition questions the reduction of disease to a sum of individual risk factors and instead examines economic, social, environmental, and territorial processes that produce different possibilities of illness.

The Indigenous perspective expands this even further.

In 2023, Adriana Rosa Cruz Santos discussed contributions gathered in Vozes Indigenas na Saude, a work produced with leaders including Ailton Krenak, Davi Kopenawa, Celia Xakriaba, Luiz Eloy Terena, and representatives of several Indigenous peoples.

The text shows that, in different Indigenous cosmologies, health may involve body, territory, community relationships, spirituality, rivers, land, and other living beings, challenging the idea that the individual biomedical model is the only possible way to understand care.

This does not mean replacing scientific medicine with tradition.

It means building a State capable of using technology and evidence without erasing the knowledge of those who live in the territory.

Where do EEG and NIRS fit?

Decolonial Neuroscience does not abandon the brain.

It questions the idea that the brain alone can explain the full experience of health.

Brazilian researchers from Hospital de Clinicas de Porto Alegre and UFRGS published a 2022 study using fNIRS in women with fibromyalgia. The study observed patterns of cortical connectivity associated with pain responses.

Also in 2022, researchers including teams from UFRJ published a protocol combining fNIRS and EEG to study brain mechanisms related to pain modulation in patients with head and neck cancer.

These technologies allow us to observe important parts of the process.

But a cortical signal cannot tell us by itself whether a person has food, housing, safety, money for transportation, or family support.

The brain shows part of the experience. Body-Territory tries not to lose what happened around it.

SUS VIP: a possible expansion of the SUS

From this scenario, we propose studying a new possibility.

SUS VIP

The name is intentionally provocative, but the idea would not be to create a better SUS only for those who can pay.

The universal SUS would remain a right for everyone, free at the point of access and financed by the State.

SUS VIP would be a complementary and voluntary model.

A person could choose to contribute directly to the public system with an amount equivalent, for example, to 60 percent of the price of a comparable private health insurance plan.

In return, the person would enter a complementary healthcare network administered or contracted by the SUS.

When there is a clinically necessary consultation, diagnostic test, procedure, surgery, medicine, or high-complexity intervention, the SUS VIP fund would cover the additional cost necessary to guarantee treatment.

Care could take place:

within the public network,

within the nonprofit network,

within accredited private providers,

at specialized national centers,

and, in exceptional and clinically justified cases, outside Brazil, when a necessary treatment has no equivalent alternative available in the country.

This proposal does not currently exist in these terms and does not belong to any of the candidates analyzed here.

It is a BrainLatam hypothesis that would require actuarial, constitutional, regulatory, and economic modeling before any implementation.

The SUS already interacts with private healthcare

The idea of using private healthcare capacity for the benefit of the SUS does not start from zero.

Today, when a person with private health insurance receives treatment through the SUS for a service covered by their policy, there is already a reimbursement mechanism through which insurers repay the public system.

In addition, the Agora Tem Especialistas program allows health insurance companies to convert certain SUS reimbursement debts into consultations, diagnostic tests, surgeries, and other services delivered directly to SUS patients.

SUS VIP would ask a different question:

What if some people who currently finance only private health insurance could choose instead to directly finance a complementary layer of the public health system?

What would need to be protected

To remain compatible with the universal logic of the SUS, SUS VIP would have to be designed so that it does not remove resources from the universal system or create a privileged queue inside the existing public structure.

Additional contributions would need to create additional capacity.

This could include:

contracting unused medical capacity,

funding new equipment,

expanding university hospitals,

contracting procedures,

funding high-complexity centers,

negotiating medicines,

funding exceptional international treatment,

and using technology to organize a national care network.

Clear controls would also be needed for medical indication, auditing, costs, fraud, data protection, and experimental treatments.

The objective would be to ensure that additional money increases the overall capacity of the system, rather than simply competing for the capacity that already exists.

From SUS VIP to Body-Territory

Even an extremely efficient SUS VIP would still face a question.

After treatment, where does the person return?

To the same water?

The same food?

The same job?

The same violence?

The same pollution?

The same temperature?

The same lack of sanitation?

This is why expanding access to medical procedures is only one part of the proposal.

The other is enabling the State to recognize that preventing illness also means protecting territories.

From the person's medical record to the health status of the territory

Perhaps the future of the SUS could combine two levels.

The individual medical record would continue documenting the patient's clinical history.

At the same time, the State could monitor public and anonymized indicators of territorial health:

water,

sanitation,

temperature,

pollution,

violence,

food security,

disease,

mental health,

commuting time,

vegetation coverage,

disease vectors,

climate vulnerability.

The question would be:

Is this territory becoming more or less capable of sustaining health?

One question for all presidential candidates

Lula proposes strengthening and digitalizing the SUS.

Flavio Bolsonaro proposes telehealth, home care, and greater integration with private healthcare capacity.

Zema proposes expanding integration between the SUS and the private network.

Caiado prioritizes waiting lists, prevention, technology, and management.

Renan Santos proposes clinical risk classification.

Augusto Cury emphasizes prevention and emotional health.

Clariana Barao proposes artificial intelligence and telemedicine.

Edmilson Costa and Rui Costa Pimenta propose nationalizing healthcare within broader socialist transformations.

Hertz Dias proposes structural change within a socialist program.

Samara Martins begins from the defense of public services and her own experience within the Family Health Strategy.

Wilson Grassi proposes One Health.

Pablo Marcal should be incorporated when a verifiable plan becomes available.

These are different proposals.

We do not determine which is superior.

Decolonial Neuroscience and Body-Territory add the same question to all of them:

After four years, will Brazil merely have more capacity to treat disease, or will it also have territories capable of producing less illness?

The hospital may remain indispensable.

But healthcare in the twenty-first century may need to learn how to arrive much earlier.

Because by the time the body finally enters the hospital, part of its health story has already happened.

In the water. In the food. In the home. At work. In the community. In the climate. In culture. In the territory.

And it is precisely this history that Body-Territory proposes the State should also learn to see.

References

Brazilian Ministry of Health. Unified Health System and the principles of universality, comprehensiveness, and free access.

Brazilian Ministry of Health. Equity within the SUS and social conditions of life.

Brazilian National Supplementary Health Agency. Reimbursement to the SUS.

Brazilian National Supplementary Health Agency. Agora Tem Especialistas program and use of private healthcare capacity.

Sevalho, Gil. Social determination of health, complexity, coloniality, and long duration. Cadernos de Saude Publica, 2024.

Santos, Adriana Rosa Cruz. Indigenous voices in health: reclaiming territories of speech in the silent colonial night. Cadernos de Saude Publica, 2023.

Franco, Alvaro de Oliveira et al. Functional connectivity response to acute pain assessed by fNIRS is associated with BDNF genotype in fibromyalgia. Scientific Reports, 2022.

Moura, Brenda de Souza et al. Study Protocol of tDCS Based Pain Modulation in Head and Neck Cancer Patients Under Chemoradiation Therapy Condition: An fNIRS-EEG Study. Frontiers in Molecular Neuroscience, 2022.