Condições sociais de surgimento e implementação de uma política pública : burocratas e médicos na foamação das políticas de saúde no Brasil (1963-2004)

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

The Brazilian health policies between 1963 and 2004, if regarded only at the legal features, follow a path of increasing incorporation of larger portions of the population, until the universalization of the healths right, in the second part of the eighties, along with the creation of the Single Health System (SUS). However, notwithstanding all the legal changes, the health policies, if regarded on their social dynamics, kept a pattern where the social divisions set the access to the healthcare. The constitutional modifications along the period were not enough to change the fragmentary and residual pattern of state intervention on the health sector. During the period, two interest groups remained as the main mediators of the policies in the sector: the state bureaucracy and the physicians. The bureaucracy due its strategic position inside the State. The physicians due its strategic position inside de healths sector organization. It was the social security and healths bureaucracy the force driving the two mains reforms in the sector: the social security unification, in 1967, and the so-called sanitary reform. The sanitary reform led to the health chapter on the Federal Constitution of 1988 and the creation of the Single Health System (SUS). However, the ability to introduce legislative innovation was limited to the state arena, without affecting the social dynamic. Physicians, on the other hand, were able to preserve their financial and technical autonomy when facing State expansion on the health sector. As the Canadian case study seems to show, there is no opposition between liberal practice and State expansion in the health sector, as long as the state expansion was kept limited to an income ceiling. That interest was preserved in the Brazilian Case. However, in keeping the liberal practice untouched, it kept the conditions for the sector expansion, without solving the access problem. It concludes that the distance between the universalist model and the residual social dynamic in the period of the study are the result of disputes among the interest groups to keep their position inside the sector and/or their share in the distribution of health goods.

ASSUNTO(S)

saúde pública professions política de saúde - burocracia bureaucracy política de saúde public policies sociologia welfare system single health system (sus), canada health policies

ACESSO AO ARTIGO

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