O fundo público e os impasses do financiamento da saúde universal brasileira

Abstract

The objective of this article is to review the theoretical approach about Francisco de Oliveira's (1998b) public fund, in order to contribute to a deep analysis on health and social security financing constraints. The first part discusses the concepts of public fund and its relation to social policies financing, identifying this author's view in respect to public fund as anti-value, and also deals with the present critics in recent literature about his studies, by Behring (2009). In accordance with this analysis, it argues, in the context of financing contemporary capitalism and in the present capital crisis, about the fragilities that the concept of public fund anti-value has been facing. The second part, inspired by the first, deals with the process of Social Security and SUS financing institutionalization in the years of 1990's and 2000's, with particular interest to its facing constraints.

Organizações Sociais do setor de saúde no estado de São Paulo: avanços e limites do controle externo

“…Para isso, entende-se que é preciso, mais do que nunca, repolitizar o debate no campo sanitário e retomar a exigência do financiamento integral da atenção à saúde, sob pena de futuras mudanças e proposições serem inúteis do ponto de vista da resolução dos problemas. Diferentes pesquisadores abordam o tema da apropriação do fundo público pelo capital com consequente retração das políticas de bem-estar social; dentro dos limites dados pela ordem do capital, o SUS, como ensaio do Estado de Bem-Estar Social brasileiro, não poderá se constituir genuinamente, pois isso pressupõe uma transformação radical na forma de produzir e distribuir a riqueza (Behring, 2015;Mendes, 2014;Behring e Boschetti, 2011;Salvador, 2010).…”

Outsourcing and "dismantling" of steady jobs at hospitals

“…The universal right to healthcare included in the 1988 Brazilian constitution was constrained by underbudgeting over the past 27 years -precisely those years when financial capital (interest-bearing capital, according to Marx) (16) , especially in its more perverse form of fictitious capitalwas sovereign among the different types of capital, industrial and commercial. Among other effects, its action has been hurting government budgets, which compromises the maintenance of rights related to the so-called welfare state or the realization of new rights in countries that have been lagging in this process, like Brazil (17) .…”

“…The presence of fictitious capital cannot be seen as lack of controls or distortion; on the contrary, it is part of capital's relentless self-valuing process -in the context of industrial capital's retreat -regardless of being fictitious, not producing any added value, and functioning in a speculative way (15)(16)(17) . As Marx argues in the third book of Capital (16) , it is the most fetishist form of capital: money that makes money, without going through production.…”

“…Actually, the foundation of the capitalist structural crisis lies on the existence of two main trends that have been articulated, especially from the late 1960s: the trend of a decline in the profit rate of the capitalist economies and the response to this trend, i.e., financial capital hypertrophy, specifically fictitious capital, which began to lead the dynamics of capitalism in that period and became central in the world's economic and social relations, particularly from 1980 (15)(16)(17) .…”

O pensamento de Amélia Cohn sobre a reforma sanitária brasileira

“…Esse seria, portanto, um empecilho para a adoção de políticas drásticas de redistribuição do patrimônio e da renda. A título de exemplo, na área social e da saúde, alguns estudos vêm mostrando os impasses às políticas sociais causados pela utilização do fundo público por um setor privado financeirizado(GRANEMAN, 2007;MENDES, 2014;BAHIA, 2018). políticas sociais redistributivas e discute as consequências da crescente acumulação de capital na saúde para a garantia dos direitos sociais e sobre o papel do Estado.…”