reporter: in downtown rio, we stumbled on a storefront setup offering free vaccinations against measles, mumps and rubella. a woman in line was shocked to hear from me that shots in the states aren't always free. but offering so much to so many has put a strain on the system. >> everything is given and everything is a right of everyone, and everything is free. so it is impossible, basically, doing that. >> reporter: with the current focus on primary care, it often battles for resources with brazil's hospitals. and the result, the hospitals often come up short. a recent study by the world bank called most of brazil's hospitals substandard and said that many deliver inefficient, poor quality care. >> the hospitals are a very serious problem. >> reporter: are there long waits for complex procedures? >> absolutely. yeah. very long waits and sometimes very bad quality. >> reporter: isn't this an inevitable consequence when you try to be all things to all people? >> no, no. because we have to have a social responsibility regarding health. ideally, you have to provide optimal health care to everyone.