"Just to make sure to clarify that the health care ask is for retirees - not for families with children.
Assuming that expat retirees are able to afford private insurance or private care in case of emergency, is it possible to use the public system to get stabilized and then transferred to the more specialized care center in another city / state?
For example, in the US, there are few specialized hospitals and it's very common to get stabilized locally and then transferred. "
My answer....
Retires or children the demand is the same.聽 聽
The public system can be used only if you are a foreign national who has legal residence in Brazil, The equivalent of a Green Card here would be the RNE ID.聽 聽Then, upon claiming domicile in any given town, you get your utility bills and make a run towards the local public聽 city maintained community health center and ask them to get a SUS card issue.聽 That should take no more than a week.
Granted, the public health care, SUS , is a last resort resource.聽 聽if there is a major public hospital in your chosen town, even under emergency care, their triage might send you straight to the local public infirmary before they decide you need to be at the hospital.
That being said, even as the SUS program is a Federally funded one, the quality varies by Municipality and State.聽 聽And with that, there are better States and or Cities than others, when it comes to patient overload, facilities, availability of specialized care, diagnostic labs nearby.聽
For the sake of argument, I had next door neighbors, in Santo Andre-SP, now retired, who opted to move to a coastal community ( Caraguatatuba-SP ).聽 They came back, after realizing they need care, and at that town,. the publicly funded care was substandard.聽 聽So after selling their city聽 home where they resided for many years, they sold the beach house, and bought a smaller and more affordable place in Santo Andre.聽
Another example...,.
In my town, through the public clinic ( which isn't great but the general practicioner is usefull on prescriptions and getting diagnostic exames ordered ), directs most exams , short of blood, to the local Non-Profit "Casa da Esperanca:" which takes insurance, private payment, and the public vouchers for your CAT Scan or X-Ray.聽 The clinic, which maintain a body of special;ists, and state of art diagnostic equipment, was originally funded by the Lions Club International.
So that luxury makes Public Health Care more tolerable. Still , we do have a luxury to choose whatever private hospital we want, and since we are not insured, at any level of affordability and effectiveness we can manage.
In your specific case, you might want to consider that , if your choice of living community does not have a Health Care Cluster up to snuff, at the very least it is a 30 min to an hour drive to the nearest one.聽
Cities with decent public health care infra-structure have common tell tale signs, such as...
-A diversified economy
-A strong tax base ( property tax and State and Federal allocation of resources )
-Decent up to code core ubanization
-An aging population and prorgrams to elderly people
-Low dispariy on income gap. Too many paupers overload the public health system.
-A balance on public neighborhood health clinics, publlic infirmaries, and at least more than two hospitals.
-A sizeable number of practitioners.
