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Erschienen in:
Introduction: The Universalization of Health Care in Emerging Economies Kapitel lesen Erstes Kapitel lesen

2017 | OriginalPaper | Buchkapitel

7. Universalizing Health Care in Brazil: Opportunities and Challenges

verfasst von : Ana Luiza d’Ávila Viana, Hudson Pacífico da Silva, Ilcheong Yi

Erschienen in: Towards Universal Health Care in Emerging Economies

Verlag: Palgrave Macmillan UK

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Abstract

This chapter explains the development of the Brazilian Unified Health System (SUS) within a hybrid development policy regime of neoliberal and new developmentalist policies. Focusing on three key dimensions for the development of health care in the Brazilian federative context— namely the regionalization of health care, stable and sufficient financing and public–private partnership—the chapter highlights the opportunities and challenges in moving towards universal health coverage in a context of great regional inequality, chronic underfunding and complicated relations between the public and private sectors. It argues that the creation and development of the SUS was a key driver towards the universalization of health coverage, and opened a window of opportunity to create a virtuous complementarity between health care expansion and other policies for overall development.

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Vorheriges Kapitel Political and Institutional Drivers of Social Security Universalization in Brazil
Nächstes Kapitel What Kind of Welfare State Is Emerging in China?
Fußnoten
1
In 2010 a group of prominent Brazilian and international scholars debated and approved a manifesto entitled Ten Theses on New Developmentalism. Accessed 7 March 2016. http://​www.​tenthesesonnewde​velopmentalism.​org/.
 
2
Boing et al. (2014), Barros et al. (2011), Knaul et al. (2011).
 
3
However, the fact that the health care insurance and plans industry in Brazil presents a high level of customer complaints, especially concerning coverage among the elderly (Vieira Junior and Martins 2015), is an indication that patients find barriers to accessing appropriate services.
 
4
Such as The Nursing Staff Professional Training Project (Profae) which employed 13,200 nurses to train 230,000 auxiliary nurses; The SUS Open University (UNA-SUS) which comprises public universities, state health secretariats, and telemedicine units; and the More Physicians Programme (Mais Médicos) which attracts international medical graduates to work in primary care units in more remote areas of the country.
 
5
It is difficult to identify which political parties belonged to democratic or conservative political forces in Brazil in the 1990s, since the country was one of the most fragmented in the world. The ideological map of political parties in Brazil is not clear, and the differences between parties are constantly shrinking as the parties move towards the centre of the political spectrum. See Power and Zucco (2009), Lucas and Samuels (2010), Samuels and Zucco (2013).
 
6
Melo (1996), Costa (2002), Noronha and Soares (2001).
 
7
Law 8080, of 19 September 1990, provides information about conditions for the promotion, protection and recovery of health, the organization and functioning of the corresponding services and other provisions. Law 8142, of 28 December 1990, provides on community participation in the management of the SUS and on intergovernmental transfers of financial resources in health.
 
8
Ministerial Directive GM/MS 95, 26 January 2001. Approves the Health Care Operational Regulations (NOAS-SUS 01/2001).
 
9
Ministerial Directive GM/MS 399, 22 February 2006. Promotes the Pact for Health 2006—Consolidation of the SUS and approves the Operational Directives of the Pact.
 
10
Decree 7508, of 28 June 2011. Regulates Law 8080 of 19 September 1990 that calls for the organization of the Unified Health System (SUS) to provide health planning, inter-federative relations, health care and other services.
 
11
The contract must be signed by the Brazilian Ministry of Health (at the federal level), the Governor and Secretary of State for Health (at the state level), and the Mayor and Municipal Secretary of Health (at city level). As of October 2014, only two states (out of 26) had signed the Organizational Public Action Contract together with their municipalities and the Federal Government.
 
12
Estimates show that approximately USD 200 billion were subtracted from the Social Welfare budget in the period 2005–2013 (ANFIP 2014).
 
13
Purchasing Power Parity at international dollar rate.
 
14
Some products manufactured via PDP are already being acquired by the Brazilian Ministry of Health, such as clozapine, imatinib mesylate, olanzapine, quetiapine, rivastigmine, tacrolimus, tenofovir and some vaccines (Brazil 2013b). Figures retrieved from http://​www.​blog.​saude.​gov.​br/​index.​php/​570-destaques/​34290-saude-cria-nova-regulacao-para-a-producao-nacional-de-medicamentos-e-equipamentos (accessed July 2015).
 
15
Estimated trade deficit for 2014 is approximately USD 11 billion.
 
16
Roughly 70 percent of the health establishments in Brazil that do not offer hospitalization are now public, while the gap between the number of public and private hospital beds is shrinking (IBGE 2010).
 
17
Law 13097, of 20 January 2015, which amended Law No. 8080/1990, alters Law 8080, of 19 September 1990.
 
Literatur
Almeida, Maria H.T. 2007. O Estado no Brasil contemporâneo. In A democracia brasileira: Balanço e perspectivas para o século 21, ed. C.R. Melo and M.A. Sáez, 17–37. Belo Horizonte: Ed. UFMG.
ANFIP (Associação Nacional dos Auditores Fiscais da Receita Federal do Brasil). 2014. Análise da seguridade social. Brasília: ANFIP.
Araujo, H., Cyntia Azevedo, and Sílvio Cost. 2012. Fiscal consolidation and macroeconomic challenges in Brazil. BIS Papers 67: 91–102.
Arretche, Marta T.S. 2009. Continuidades e descontinuidades da Federação Brasileira: de como 1988 facilitou 1995. Dados 52(2): 377–423.CrossRef
Avritzer, Leoardo. 2009. Participatory institutions in democratic Brazil. Washington, DC: Woodrow Wilson Center Press.
Ban, C. 2013. Brazil’s Liberal Neo-developmentalism: New paradigm or edited orthodoxy? Review of International Political Economy 20(2): 298–331.CrossRef
Barreto, Mauricio L., Davide Rasella, Daiane B. Machado, Rosana Aquino, Diana Lima, Leila P. Garcia, Alexandra C. Boing, Jackson Santos, Juan Escalante, Estela M.L. Aquino, and Claudia Travassos. 2014. Monitoring and evaluating progress towards Universal health coverage in Brazil. PLoS Medicine 11(9): e1001692.
Barros, Aluísio J.D., João Luiz Bastos, and Andréa H. Dâmaso. 2011. Catastrophic spending on health care in Brazil: Private health insurance does not seem to be the solution. Cadernos de saúde pública 27(Sup 2): S254–S262.
Bauman, Zygmunt. 2011. Collateral damage: Social inequalities in a global age. Cambridge: Polity Press.
Boing, Alexandra Crispim, Andréa Dâmaso Bertoldi, Aluísio Jardim Dornellas de Barros, Leila Garcia Posenato, and Karen Glazer Peres. 2014. Socioeconomic inequality in catastrophic health expenditure in Brazil. Revista Saúde Pública 48(4): 632–641.
Bresser-Pereira, Luiz Carlos. 2012a. Structuralist macroeconomics and the new developmentalism. Brazilian Journal of Political Economy 32(3): 347–366.
Bresser-Pereira, Luiz Carlos. 2012b The new developmentalism as a Weberian ideal type. Texto para Discussão 319. São Paulo: FGV-EESP.
Cohn, Amelia. 2008. The Brazilian health reform: A victory over the neoliberal model. Social Medicine 3((2): 71–81.
Costa, Ricardo Cesar Rocha. 2002. Descentralização, financiamento e regulação: a reforma do sistema público de saúde no Brasil durante a década de 1990. Revista Sociologia e Política 18: 49–71.
Dourado, Daniel, and Pablo Eduardo Elias. 2011. Regionalization and political dynamics of Brazilian health federalism. Revista de Saúde Pública 45(1): 204–211.CrossRef
Elias, Pablo Eduardo, and Amelia Cohn. 2003. Health reform in Brazil: Lessons to consider. American Journal of Public Health 93(4): 44–48.CrossRef
Gadelha, Carlos Augusto Grabois, Cristiani Vieira Machado, Luciana Dias de Lima, and Tatiana Wargas de Faria Baptista. 2009. Saúde e desenvolvimento: Uma perspectiva territorial. In Saúde, desenvolvimento e territorio, ed. A.L.D. Vaina, P.E. Elias, and N. Ibañez, 97–123. São Paulo: Hucitec.
Gragnolati, Michele, Magnus Lindelow, and Bernard Couttolenc. 2013. Twenty years of health system in Brazil: An assessment of the Sistema Único de Saúde. Washington DC: World Bank.CrossRef
IPEA (Institute of Applied Economic Research). 2012a. A década inclusiva (2001–2011): Desigualdade, pobreza e políticas de renda. Comunicados do IPEA, 155.
———. 2012b. PNAD 2011: Primeiras análises sobre o mercado de trabalho brasileiro. Comunicados do IPEA, 156.
Knaul, Felicia Maire, Rebeca Wong, Héctor Arreola-Ornelas, M Health Econ, Oscar Méndez, Analis, and Network on Health Financing and Social Protection in Latin America and the Caribbean (LANET). 2011. Household catastrophic health expenditures: A comparative analysis of twelve Latin American and Caribbean countries. Salud Pública de México 53(Suppl 2): 85–95.
Levcovitz, Eduardo, Luciana Dias Lima, and Cristiani Vieira Machado. 2001. Política de saúde nos anos 90: Relações intergovernamentais e o papel das Normas Operacionais Básicas. Ciência e Saúde Coletiva 6(2): 269–291.
Lucas, Kevin, and David Samuels. 2010. The ideological ‘coherence’ of the Brazilian party system, 1990–2009. Journal of Politics in Latin America 2(3): 39–69.
Melo, Marcus André. 1996. Crise federativa, guerra fiscal e “hobbesianismo municipal”: Efeitos perversos da descentralização? São Paulo em Perspectiva 10(3): 11–20.
Noronha, José Carvalho, and Laura Tavares Soares. 2001. A política de saúde no Brasil nos anos 90. Ciência e Saúde Coletiva 6(2): 445–450.
Paim, Jairnilson, Claudia Travassos, Celia Almeida, Ligia Bahia, and James Macinko. 2011. The Brazilian health system: History, advances, and challenges. The Lancet 377(9779): 1778–1797. Also published as O sistema de saúde Brasileiro: História, avanços e desafios. Série Saúde no Brasil 1. The Lancet 9 May: 11–31.
Piola, Sérgio F., Andrea Barreto de Paiva, Edvaldo Batista de Sá, and Luciana Mendes Santos Servo. 2013. Financiamento público da saúde: Uma história à procura de rumo. Texto para Discussão, 1846. Rio de Janeiro: IPEA.
Power, Timothy J., and Cesar Zucco Jr. 2009. Estimating ideology of Brazilian legislative parties, 1990–2005: A research communication. Latin American Research Review 44(1): 218–246.CrossRef
Ribeiro, Patrícia Tavares. 2009. A descentralização da ação governamental no Brasil dos anos noventa: Desafios do ambiente político-institucional. Ciência e Saúde Coletiva 13(3): 819–828.
Sallum Jr., Brasilio. 2004. Crise, democratização e liberalização no Brasil. In Brasil e Argentina hoje: Política e economía, ed. Brasilio Sallum Jr., 47–77. Bauru: EDUSC.
Samuels, David, and Cesar Zucco Jr. 2013. The power of partisanship in Brazil: Evidence from survey experiments. American Journal of Political Science 58(1): 212–225.CrossRef
Siscú, J., L.F. Paula, and P. Michel. 2007. Why new developementalism? Revista de Economia Política 27(4): 507–524.CrossRef
Souza, Celina. 2002. Governos e sociedades locais em contextos de desigualdades e de descentralização. Ciência e Saúde Coletiva 7(3): 431–442.
Vargas, Ingrid, Amparo Susana Mogollón-Pérez, Jean-Pierre Unger, Maria Rejane Ferreira da-Silva, Pierre De Paepe, and María-Luisa Vázquez. 2014. Regional-based integrated health care network policy in Brazil: From formulation to practice. Health Policy and Planning 30(6): 360–367.
Viana, Ana Luiza D’Ávila. 2014. Descentralização e políticas de saúde: Origens, contexto e alcance da descentralização. São Paulo: Hucitec.
Viana, Ana Luisa D’Ávila, and Hudson Pacífico Silva. 2012. Relações estado, mercado e sociedade no Brasil: Arranjos assistenciais produtivos na saúde. In S aúde desenvolvimento, ciência, tecnologia e inovação, ed. Ana Luisa D’Ávila Viana, Nelson Ibañez, and Aylene Bousquat, 105–132. São Paulo: Hucitec.
Viana, Ana Luiza D’Ávila, Luciana Dias de Lima, and Roberta Gondim de Oliveira. 2002. Decentralization and federalism: The health politics in new context—Lessons of the Brazilian case. Ciência e Saúde Coletiva 7(3): 493–507.
Viana, Ana Luiza D’Ávila, Márcia Cristina Rodrigues Fausto, and Luciana Dias de Lima. 2003. Política de saúde e eqüidade. São Paulo em Perspectiva 17(1): 58–68.
Viana, Ana Luiza D’Ávila, Luciana Dias de Lima, and Maria Paula Ferreira. 2010. Structural conditions for regionalization in healthcare: Typology of regional management boards. Ciência e Saúde Coletiva 15(5): 2317–2326.
Vieira Junior, Wilson Marques, and Mônica Martins. 2015. The elderly and healthcare plans in Brazil: Analysis of the complaints received by the national regulatory agency for private health insurance and plans. Ciência and Saúde Coletiva 20(12): 3817–3826.CrossRef
Metadaten
Titel
Universalizing Health Care in Brazil: Opportunities and Challenges
verfasst von
Ana Luiza d’Ávila Viana
Hudson Pacífico da Silva
Ilcheong Yi
Copyright-Jahr
2017
Buch
Towards Universal Health Care in Emerging Economies

Print ISBN: 978-1-137-53376-0

Electronic ISBN: 978-1-137-53377-7

Copyright-Jahr: 2017

DOI
https://doi.org/10.1057/978-1-137-53377-7_7

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