Politicization, Repression, and National Health: The Brazilian Military Regime and the Medical Sector, 1964–85

This paper explores the intricate interplay between the Brazilian military regime (1964-1985) and the medical sector. Relying on reports of intelligence agencies, government records, and archives of medical associations and student groups, it reveals how the regime intensified and then utilized stark divisions among medical practitioners to remake both their professional sector and national health policies. Preceding the military takeover, Brazil was already beset by social unrest and political paralysis. Dire public health conditions and limited access to medical care politicized and divided physicians. Some doctors advocated preventive care programs for the poor and the integration of social medicine into professional training. Their opponents called for a liberal, privately-run medical system based on individualized care. The professional disagreements quickly turned into public policy questions, linked to and amplifying sociopolitical conflicts.

The polarization of the sector had exacerbated following the 1964 coup, the paper shows, as the military forced medical research institutions to expel “subversive” physicians, and counted on the backing of many of their professional rivals. When state repression escalated towards the late 1960s, security forces suspended activities of “disloyal” doctors’ unions, quelled medical students’ protests, and detained activist physicians. The result was not only the disappearance of the terms “social” and “community health” from professional vocabularies, but also a decade of uncontested conservative rule in medical regulatory bodies. Consequently, the paper argues, government technocrats had free rein to install a new social healthcare program—that only served the urban employed—as well as advance a lucrative industry of private healthcare plans. In analyzing the regime’s dealings with the medical sector, the paper demonstrates how professional agendas, ideologies, and state-led repression were critical in shaping both medical practice and health policy under military Brazil.