Políticas de Saúde na Argentina, Brasil e México: diferentes caminhos, muitos desafios

Abstract

Over recent decades, several Latin American health systems have undergone reforms. This paper analyzes health policies in Argentina, Brazil and Mexico from 1990 to 2014. It explores the reform strategies, explanatory factors and effects on the configuration of each health system. The analytical framework was based on the historical-comparative approach and considered the following aspects: political and economic context; health reform agendas, processes and strategies; changes in the health system configuration in terms of social stratification and de-commodification. The research methods involved literature review, document and data analysis and interviews. In the period, Argentina maintained an employment-based and fragmented healthcare system, expanded specific public programs and private health plans. Brazil created a public and universal health system, which coexists with a dynamic and growing private sector. Mexico maintained the employment-based health care and created a popular health insurance. Although the reform influences and strategies varied between the countries, social stratification and commodification persisted in the three health systems, under different arrangements.The transformation of these characteristics is essential to build universal health systems in Latin America.

Sistema Nacional de Farmacovigilância no Brasil e em Portugal: semelhanças, diferenças e desafios

“…No que diz respeito ao contexto político-social, ainda que existam semelhanças entre Brasil e Portugal, na cultura, história e algumas características do sistema de saúde, persistem diferenças como maior desigualdade econômica no Brasil, com menor índice de desenvolvimento humano, seguros privados em expansão e elevado gasto direto das famílias com saúde 9,21 . A política pública de saúde, no Brasil, não conseguiu superar a fragmentação das ações de saúde e a força dos mercados de saúde, que disputam com ele os recursos do Estado e da sociedade, sendo capaz de ameaçar sua viabilidade 22 . A regulação de medicamentos e a farmacovigilância estão inseridas nesse macrocontexto.…”

Strengthening health systems to achieve Universal Health Coverage: Lessons from four Latin American countries.

“…[15,16,18,21] Other programs strengthened primary care by targeting public sector coverage. [26] For instance, Argentina implemented the Programa de Medicos Comunitarios [Community Doctors Program] (2004 to 2007), which applied differential payments to family medicine and general practice physicians working within primary care centers. [19] Brazil Brazil has a dual public/private healthcare system.…”

Salud es política: pensamiento social de Floreal Antonio Ferrara y sus contribuciones para repensar “lo político” en la salud

“…Desde el nacimiento de la salud colectiva en Brasil, la herencia socialdemócrata colonizó el pensamiento político de este campo (1), desalentando el desarrollo del político a través de otras matrices interpretativas. El enfoque marxista brasileño (2)(3)(4) que inicialmente conducía los debates en este campo, en los años setenta y ochenta, cedió espacio a otros saberes de orígenes postmodernos (5,6) y neoinstitucionalistas (7,8), abandonando gradualmente la crítica política de la ideología dominante de una manera totalizante (9).…”