0194/2018 - Políticas de Saúde na Argentina, Brasil e México: Diferentes caminhos, muitos desafios. Health Policies in Argentina, Brazil and Mexico: Different paths, many challenges.
Nas últimas décadas, vários sistemas de saúde latino-americanos passaram por reformas. O artigo analisa as políticas de saúde no Argentina, Brasil e México de 1990 a 2014, explorando estratégias, condicionantes e efeitos das reformas sobre a configuração dos sistemas de saúde. Adotou-se a abordagem histórico-comparativa, considerando os eixos: trajetória da política de saúde; contexto político e econômico; agendas, processos e estratégias de reforma; mudanças na configuração do sistema, em termos de estratificação social e desmercantilização. A pesquisa compreendeu revisão bibliográfica, análise documental, de dados secundários e entrevistas. No período, a Argentina manteve na saúde o sistema corporativo fragmentado, com expansão do setor privado e de programas públicos específicos. O Brasil implantou um sistema público universal, que convive um setor privado dinâmico e crescente. O México manteve o seguro social dos trabalhadores e criou um seguro de saúde para pobres. Em que pesem as diferenças nos condicionantes e estratégias de reforma, nos três países persistiram a estratificação social e a mercantilização em saúde, sob formas variadas. A transformação dessas características é fundamental para a construção de sistemas de saúde universais na América Latina.
Palavras-chave:
Sistemas de Saúde; América Latina; Relações Público-Privadas em Saúde.
Abstract:
In the last decades, several Latin American health systems have undergone reforms. This paper analyzes health policies in Argentina, Brazil and Mexico1990 to 2014. It explores the reform strategies, explanatory factors and effects over the configuration of each health system. The analytical framework was based on the historical-comparative approach and considered: political and economic context; health reform agendas, processes and strategies; changes in health system´s configuration in what regards social stratification and decommodification. Research methods involved literature review, document and data analysis and interviews. In the period, Argentina maintained an employment-based and fragmented healthcare system, expanded specific public programs and private health plans. Brazil created a public and universal health system, which coexists with a dynamic and growing private sector. Mexico maintained the employment-based health care and created a popular health insurance. Although the reform influences and strategies varied between the countries, social stratification and commodification persisted in the three health systems, under different arrangements. The transformation of these characteristics is essential to build universal health systems in Latin America.
Keywords:
Health Policies; Health Systems; Latin America; Public-private relations in health.
Health Policies in Argentina, Brazil and Mexico: Different paths, many challenges.
Resumo (abstract):
In the last decades, several Latin American health systems have undergone reforms. This paper analyzes health policies in Argentina, Brazil and Mexico1990 to 2014. It explores the reform strategies, explanatory factors and effects over the configuration of each health system. The analytical framework was based on the historical-comparative approach and considered: political and economic context; health reform agendas, processes and strategies; changes in health system´s configuration in what regards social stratification and decommodification. Research methods involved literature review, document and data analysis and interviews. In the period, Argentina maintained an employment-based and fragmented healthcare system, expanded specific public programs and private health plans. Brazil created a public and universal health system, which coexists with a dynamic and growing private sector. Mexico maintained the employment-based health care and created a popular health insurance. Although the reform influences and strategies varied between the countries, social stratification and commodification persisted in the three health systems, under different arrangements. The transformation of these characteristics is essential to build universal health systems in Latin America.
Palavras-chave (keywords):
Health Policies; Health Systems; Latin America; Public-private relations in health.
Machado, C. V.. Políticas de Saúde na Argentina, Brasil e México: Diferentes caminhos, muitos desafios.. Cien Saude Colet [periódico na internet] (2018/Abr). [Citado em 08/11/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/politicas-de-saude-na-argentina-brasil-e-mexico-diferentes-caminhos-muitos-desafios/16727?id=16727&id=16727
