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Recebido com vaias por parte da plateia no evento que reúne os prefeitos dos mais de 5.500 municípios brasileiros, o presidente Luiz Inácio Lula da Silva teve de esperar o sânimos se acalmarem antes de começar seu discurso. Sem perder a compostura, apelou à cordialidade e à parceria institucional: “O governo tem que olhar vocês, prefeitos, não como adversários, mas como aliados da execução das políticas públicas”, disse na Marcha dos Prefeitos nesta terça-feira, 20. “Os programas que o governo federal anuncia, se não tiver o prefeito na ponta, não funcionam”, afirmou. As declarações vieram momento depois de Lula apresentar novas promessas de programas sociais.
Um deles é o “Mais Especialista”, iniciativa que mira diretamente o calcanhar de Aquiles do SUS: a fila de espera por consultas e exames especializados. Inspirado no modelo do “Mais Médicos”, o programa pretende garantir ao cidadão o direito à segunda consulta com especialista e aos exames complementares, algo que hoje está fora do alcance de milhões de brasileiros. Outra frente anunciada mira a Reforma”, lançado em 2017 e descontinuado em 2019 após baixa adesão e denúncias de má gestão.
O problema não é a ideia, mas a capacidade de execução. A dependência dos municípios para implementar essas ações é estrutural — e também o maior ponto de vulnerabilidade. Nos bastidores, prefeitos reclamam do atraso em rees de emendas, da centralização excessiva das decisões em Brasília e da asfixia fiscal que limita a autonomia dos municípios. Desde 2023, a pressão sobre as prefeituras aumentou com a queda de receitas do Fundo de Participação dos Municípios (FPM), resultado da desaceleração econômica e das desonerações federais. Como o próprio presidente reconheceu, o cidadão “morre sem ar em uma máquina de exame”. E, nesse caso, não é a falta de discurso que mata. É a ausência de execução.
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