• José Angelo Machado - Machado, José Angelo - Universidade Federal de Minas Gerais, ciência política - <joseangelo@fafich.ufmg.br>
• Luciana Assis Costa - Costa, Luciana Assis - Universidade Federal de Minas Gerais, Terapia ocupacional - <lucianaassis.ufmg@gmail.com>
Área Temática:
Políticas em Saúde
Resumo:
O artigo analisa o processo de construção institucional do Pacto pela Saúde consolidado em 2006 e que expressa uma evolução incremental do arcabouço regulatório das relações federativas no SUS. Ainda que considerando que tal processo se desenvolveu de forma privilegiada numa arena federativa paritária – a CIT – assume-se a hipótese geral da literatura brasileira sobre federalismo que sugere um papel dominante da União na formulação das políticas sociais. Utilizando a abordagem institucionalista, com foco na relação entre federalismo e políticas públicas (distribuição vertical de poder, coordenação e cooperação intergovernamental), realizou-se um estudo qualitativo a partir de entrevistas com gestores e consultores que participaram do processo, e análise das atas de reuniões da CIT (2004-2012). Os resultados apontam: a União foi detentora da iniciativa de formulação, mas houve razoável influência dos governos subnacionais; o longo período de discussões refletiu alto grau de dissenso entre os entes federados; na ausência de consenso, a questão do financiamento foi transferida para um compromisso político pela ampliação das fontes de financiamento a ser assumido pelas três esferas de governo; o Pacto não modificou a dinâmica das relações federativas quanto à conformação das redes regionais de atenção à saúde.
Palavras-chave:
política de saúdefederalismopolítica pública
Abstract:
This article analyze the institutional construction process of the Health Pact, consolidated in 2006 and that expresses an incremental evolution of the regulatory framework of federative relationships in Brazilian National Health System. Even considering that such process has developed in a federative parity arena ( CIT) it is assumed the general hypothesis of Brazilian literature about federalism that suggests the Federal Government dominant role in the formulation of social policies. Using an institutionalist approach, focusing on the relationship between Federalism and Public Policy (vertical distribution of power, coordination and intergovernmental cooperation) it was done a qualitative study starting from semi-structured interviews with managers and consultants who participated in the process and analyzing the minutes of meetings from CIT between 2004-2012. The results indicate: the federal government held the formulation initiative, but there was reasonable influence of sub national governments; the long discussions period reflected a high degree of dissent between the federated entities; as a result, the question of financing was transferred to a political commitment for expansion of funding sources to be assumed by the three spheres of government; the Health Pact did not change the dynamics federative relations regarding the frame of regional health care networks.
Health Pact: rapprochements and collisions in the federative arena
Resumo (abstract):
This article analyze the institutional construction process of the Health Pact, consolidated in 2006 and that expresses an incremental evolution of the regulatory framework of federative relationships in Brazilian National Health System. Even considering that such process has developed in a federative parity arena ( CIT) it is assumed the general hypothesis of Brazilian literature about federalism that suggests the Federal Government dominant role in the formulation of social policies. Using an institutionalist approach, focusing on the relationship between Federalism and Public Policy (vertical distribution of power, coordination and intergovernmental cooperation) it was done a qualitative study starting from semi-structured interviews with managers and consultants who participated in the process and analyzing the minutes of meetings from CIT between 2004-2012. The results indicate: the federal government held the formulation initiative, but there was reasonable influence of sub national governments; the long discussions period reflected a high degree of dissent between the federated entities; as a result, the question of financing was transferred to a political commitment for expansion of funding sources to be assumed by the three spheres of government; the Health Pact did not change the dynamics federative relations regarding the frame of regional health care networks.
Menicucci, T. M. G., Machado, José Angelo, Costa, Luciana Assis. Pacto pela Saúde: aproximações e colisões na arena federativa. Cien Saude Colet [periódico na internet] (2016/jan). [Citado em 22/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/pacto-pela-saude-aproximacoes-e-colisoes-na-arena-federativa/15467?id=15467
