0190/2021 - As reformas dos sistemas de saúde da América Latina: influências neoliberais e desafios aos Objetivos de Desenvolvimento Sustentável Health systems reforms in Latin America: neoliberal influences and challenges to the Sustainable Development Goals
Analisam-se as características das reformas dos sistemas de saúde de países da América Latina e Caribe (ALC), a evolução dos gastos públicos e dos Objetivos de Desenvolvimento do Milênio (ODM). Discutem-se as influências neoliberais nas reformas e as possíveis consequências para os Objetivos de Desenvolvimento Sustentável (ODS) que os sucederam. Método: Estudo comparado de países selecionados. Dados extraídos das plataformas CEPALStat, Global Health Observatory e MDG Indicators e de relatórios Health in the Americas disponíveis no Repositorio Institucional para Compartir Información da Organização Panamericana de Saúde. Revisão não exaustiva de literatura. Resultados: As reformas foram divididas em três períodos: até 1990 predominou a lógica nacional solidária regulada; de 1990 a 2000 avançou-se para uma lógica concorrencial de mercado; de 2001 a 2015, evoluiu-se para programas de lógica pública, mantendo-se a concorrência entre prestadores de serviços. Os gastos públicos oscilaram e as metas dos ODM analisadas não foram completamente cumpridas. Conclusão: As mudanças dos sistemas de saúde seguiram as configurações dos Estados nacionais apregoadas pelo neoliberalismo, com lógica concorrencial de mercado, fragilizando o sistema de cuidados e o alcance dos ODS.
Palavras-chave:
Sistema de Saúde, Reforma da saúde, América Latina; Objetivos de Desenvolvimento do Milênio
Abstract:
The characteristics of health system reforms in Latin American and Caribbean (LAC) countries, the evolution of public spending and the Millennium Development Goals (MDGs) are analyzed. Neoliberal influences on the reforms and the possible consequences for the Sustainable Development Goals (SDGs) that succeeded them are discussed. Method: Comparative study of ed countries. Data extractedCEPALStat, Global Health Observatory and MDG Indicators platforms as wellthe Health in the Americas reports available in the Institutional Repository for Information Sharing of the Pan American Health Organization. Non-exhaustive literature review. Results: The reforms were divided into three periods: until 1990 a regulated national solidarity logic predominated;1990 to 2000 it moved towards a market competitive logic;2001 to 2015, it evolved towards public logic programs, maintaining competition between service providers. Public spending fluctuated and the MDG targets analyzed were not completely met. Conclusion: Changes in health systems followed the configurations of national states preached by neoliberalism, with market competitive logic, weakening the care system and the achievement of the SDGs.
Keywords:
Health System, Health Reform, Latin America; Millennium Development Goals
Health systems reforms in Latin America: neoliberal influences and challenges to the Sustainable Development Goals
Resumo (abstract):
The characteristics of health system reforms in Latin American and Caribbean (LAC) countries, the evolution of public spending and the Millennium Development Goals (MDGs) are analyzed. Neoliberal influences on the reforms and the possible consequences for the Sustainable Development Goals (SDGs) that succeeded them are discussed. Method: Comparative study of ed countries. Data extractedCEPALStat, Global Health Observatory and MDG Indicators platforms as wellthe Health in the Americas reports available in the Institutional Repository for Information Sharing of the Pan American Health Organization. Non-exhaustive literature review. Results: The reforms were divided into three periods: until 1990 a regulated national solidarity logic predominated;1990 to 2000 it moved towards a market competitive logic;2001 to 2015, it evolved towards public logic programs, maintaining competition between service providers. Public spending fluctuated and the MDG targets analyzed were not completely met. Conclusion: Changes in health systems followed the configurations of national states preached by neoliberalism, with market competitive logic, weakening the care system and the achievement of the SDGs.
Palavras-chave (keywords):
Health System, Health Reform, Latin America; Millennium Development Goals
Gottems, L. B. D., Camilo, L. de P., Mavrot, C., Mollo, M. de L. R.. As reformas dos sistemas de saúde da América Latina: influências neoliberais e desafios aos Objetivos de Desenvolvimento Sustentável. Cien Saude Colet [periódico na internet] (2021/jun). [Citado em 19/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/as-reformas-dos-sistemas-de-saude-da-america-latina-influencias-neoliberais-e-desafios-aos-objetivos-de-desenvolvimento-sustentavel/18089?id=18089
