Força ou consenso: a reforma sanitária brasileira entre o dilema reformista e o minotauro da saúde

Abstract

The capitalist crisis that the world is currently undergoing, with the dismantling of the European welfare-state alerts us to analyze more deeply our country and try to understand the trajectory of its social policies, notably the SUS. If it is true that the strategic horizon of the Brazilian Health Reform is downgraded to mere administrative reform -but that would result in the SUS -today we realize that even this was downgraded to "SUS as possible." Some limitations/choices made in the theoretical framework and political strategy are analyzed -not being the only elements -contributed to the removal of strategic objectives, including the so-called Dilemma Reformer. From the rescue of theoretical health sector benchmarks and Marxist literature in which they are based, fundamentally Gramsci, will be built-critical interpretation under the light of the process of its historical results, conditioned by the internationals policies arenas and the dispute of political projects in Brazil. It presents the hypothesis that the formation of a hybrid health system in which the private sector keeps the public sector trapped by its accumulation logic -to what we call health Minotaur -keep relations with the political strategies adopted, logically conditioned by dominance of finance capital and the structural limits of the Brazilian State.