Trinta anos de Sistema Único de Saúde (SUS): uma transição necessária, mas insuficiente

Abstract

This article describes changes in the public, nonprofit, and private components of the health care networks and health insurance and health plan companies in Brazil, based on the accumulated knowledge concerning the gains and obstacles in the Brazilian Unified National Health System (SUS) and differences between policies for democratization and democratizing processes. This central premise allowed analyzing praise versus criticism for the SUS and the contemporary nature of relations between the public and private sectors, drawing on secondary data from agencies in the Executive, Legislative, and Judiciary branches. The article concludes that the highly financialized private and private-charitable sectors imposed anti-democratic and anti-democratizing standards in the use of public funds. The article further concludes that although these sectors have not raised barriers to certain public policies for the expansion of access, they nevertheless prevent the development of the SUS according to the principles set out in the 1988 Constitution.

Arranjos regionais de governança do Sistema Único de Saúde: diversidade de prestadores e desigualdade espacial na provisão de serviços

“…Starting in the 2000s, the regionalization process reinforced public-private partnerships and articulations involving governments and providers at the state and regional scales 41,42,43 in a new context of: expansion of federal and state investments 23 ; diversification of management models in service provision (including new forms of outsourcing, such as through Social Organizations) 27 ; and protagonism of some private providers (especially philanthropic providers in the hospital and diagnostic and therapeutic support segments) 37 . As a result of these processes, the interdependence between the public and private sectors in health care is increasingly significant in Brazil 44 . To this are added the attribution of countless public functions to private entities, the delegation of control over, and monitoring of, public actions to private or civil organizations and the strong imbrication of public and private funding in health policy 26 .…”

Os desafios atuais da luta pelo direito universal à saúde no Brasil

“…At the same time, the hegemony of a model of care centered on specialized and hospital care services remains unevenly deployed within the national territory. Finally, this set of services is based on an iniquitous distribution of actions and procedures between the public and private sectors, which assures the latter a higher volume of material and symbolic resources 14 .…”

Sistema Único De Saúde Versus Judicialização Da Saúde No Brasil

“…Os dados disponíveis da Pesquisa Nacional de Saúde (PNS, 2013), mostram que 57,6% dos entrevistados que não tinham plano de saúde buscaram atendimento no SUS, enquanto 12,6% pagaram pela assistência. Dos entrevistados que declararam ter contratado planos privados de saúde, 17,5% foram atendidos em estabelecimentos públicos de saúde (3,4). Contudo, tem que ser considerado que a saúde pública abrange muito mais que a assistência per se.…”