The peculiarities of health systems in Mercosurs member countries: prospects for a regional integration / As peculiaridades dos sistemas de saúde dos países membros do Mercosul: perspectivas para a integração regional

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Abstract This qualitative study, based on the comparative-descriptive and analytical-descriptive methods, identifies and historically describes the harmonization process of the health care systems of Mercosurs member countriesArgentina, Brazil, Paraguay and Uruguayin line with the regional integration process under way. It focuses on understanding (i) the historical antecedents of those countries health care systems; (ii) the contextual aspects influencing the organization of those systems; and (iii) the prospects, potentialities and limits of Mercosurs regional integration in terms of health care. The results show that there are occasions on which the strategies adopted by those countries tend to converge, such as the period of social security expansion, in the mid-20th century, and occasions on which one of them drifts away from the others due to specific breaks and circumstances, as Brazil did in the 1980s. Concerning models, Brazil adopts a beveridgian type system designed to be universal. In contrast, the Spanish-speaking countries under study adopt bismarkian model, described as based on managed competition in view of the combination of the public, private and social security subsectors that characterizes each one of them. The analysis of the path towards the harmonization of the health care systems of those four countries showed that they share different key features. One of them is that health care is determined by the more general relationship between production and social reproduction, based on factors and concepts such as international labor division, capital accumulation, power relations and adherence to the rules of international bodies. This fact is proven most clearly by the State reform processes in Latin America, which were conducted along very similar lines in all the studied countries. The regional integration process has revealed potentialities and contradictions, as well as advances and setbacks, such as the product area and surveillance. However, health care services have gradually made strides. The coordinators of the Health Ministers Meeting and of the Work Subgroup 11 Health in Mercosur that were interviewed reported historical facts that had marked the harmonization process of health care systems, both to exemplify and to explain the current institutional design of those systems. Nevertheless, the importance of retracing their history and developmentthe purpose of this study was never mentioned. The lack of a consensus regarding an integration model seems to be one of the major challenges for the bloc.

ASSUNTO(S)

mercosul sistemas de proteção social health care systems latin america sistemas de saúde américa latina mercosur social protection systems

ACESSO AO ARTIGO

Documentos Relacionados