0167/2018 - Notas sobre o futuro do SUS: Breve exame de caminhos e descaminhos trilhados em um horizonte de incertezas e desalentos. The future of the Brazilian Health System: a short review of its pathways towards an uncertain and discouraging horizon.
Este artigo apresenta uma reflexão sobre o futuro do SUS, baseado em exercícios prospectivos desenvolvidos pela iniciativa Brasil Saúde Amanhã da Fundação Oswaldo Cruz. O texto faz uma breve revisão de caminhos e descaminhos percorridos pelo SUS, tendo como marco a Constituição Federal de 1988. Destaca os movimentos pela descentralização e a subtração de recursos da saúde que reduziu a política de incremento de gastos; e acentua os arranjos públicos e privados de financiamento e provisão de serviços que resultaram na privatização setorial decorrente, principalmente, de políticas econômicas articuladas com concessão de benefícios e tributos. Analisa o financiamento do setor público através das sucessivas emendas constitucionais que resultaram na destruição da proteção social e no enfraquecimento do setor Saúde. Para o futuro o texto considera o envelhecimento populacional e analisa tendências no perfil epidemiológico, com as consequentes mudanças no modelo de cuidados de atenção à saúde. O artigo conclui, apontando os resultados do estrangulamento fiscal na organização do sistema de cuidados e a necessidade da reversão de dispositivos legais que obstaculizam o mandamento constitucional.
Palavras-chave:
Política de Saúde, Financiamento da Assistência à Saúde, Estudos Prospectivos, Política Pública.
Abstract:
This article reflects on the future of the Brazilian Unified Health System (SUS), based on the foresight exercises conducted by the Brasil Saúde Amanhã initiative of the Oswaldo Cruz Foundation. The text briefly reviews some paths followed by the SUS as referred on the Federal Constitution of 1988. It highlights the movements for decentralization and the constraint of health financial resources that reduced policies of increasing public expenditures. It examines the public and private arrangements for financing and provision of services that have resulted in sectoral privatization mainlyeconomic policies articulated with concession of fiscal benefits. It analyzes the changes in the public sector financing through successive constitutional amendments that resulted in the weakening of established social protection policies, particularly of the health sector. For the future, the text considers population aging and analyzes trends in the epidemiological profile, with consequent changes in the health care paradigm. The article concludes by pointing out the consequences of fiscal strangling in the organization of the healthcare system and the need to reverse legal provisions that hamper the fulfillment of the constitutional mandate for equity and universality.
Keywords:
Health Policy, Healthcare Financing, Foresight Studies, Public Policy.
The future of the Brazilian Health System: a short review of its pathways towards an uncertain and discouraging horizon.
Resumo (abstract):
This article reflects on the future of the Brazilian Unified Health System (SUS), based on the foresight exercises conducted by the Brasil Saúde Amanhã initiative of the Oswaldo Cruz Foundation. The text briefly reviews some paths followed by the SUS as referred on the Federal Constitution of 1988. It highlights the movements for decentralization and the constraint of health financial resources that reduced policies of increasing public expenditures. It examines the public and private arrangements for financing and provision of services that have resulted in sectoral privatization mainlyeconomic policies articulated with concession of fiscal benefits. It analyzes the changes in the public sector financing through successive constitutional amendments that resulted in the weakening of established social protection policies, particularly of the health sector. For the future, the text considers population aging and analyzes trends in the epidemiological profile, with consequent changes in the health care paradigm. The article concludes by pointing out the consequences of fiscal strangling in the organization of the healthcare system and the need to reverse legal provisions that hamper the fulfillment of the constitutional mandate for equity and universality.
Palavras-chave (keywords):
Health Policy, Healthcare Financing, Foresight Studies, Public Policy.
Noronha, J, Noronha, GS, Pereira, TRC, Costa, AM. Notas sobre o futuro do SUS: Breve exame de caminhos e descaminhos trilhados em um horizonte de incertezas e desalentos.. Cien Saude Colet [periódico na internet] (2018/Abr). [Citado em 08/11/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/notas-sobre-o-futuro-do-sus-breve-exame-de-caminhos-e-descaminhos-trilhados-em-um-horizonte-de-incertezas-e-desalentos/16700?id=16700&id=16700
