0140/2018 - Sistema universal de saúde e cobertura universal: Desvendando pressupostos e estratégias. Universal health system and universal health coverage: Assumptions and strategies.
Nos últimos anos, acirrou-se o debate internacional sobre diferentes concepções de universalidade em saúde, polarizado nas propostas de sistema universal versus cobertura universal em saúde. A concepção de cobertura universal tem sido difundida por organizações internacionais e incorporada às reformas dos sistemas de saúde de alguns países em desenvolvimento, inclusive na América Latina. O artigo explora os pressupostos e estratégias relacionados à proposta de cobertura universal de saúde. Inicialmente contrastam-se as concepções de universalidade nos modelos de cobertura universal e de sistemas universais de saúde. A seguir, contextualiza-se o debate internacional, incluindo exemplos de diferentes sistemas de saúde. Por fim, discutem-se as implicações da concepção de cobertura universal para o direito à saúde no Brasil. A análise das diferentes concepções de universalidade e das experiências de países evidenciam que arranjos de seguros (privados ou sociais) não superam as fortalezas de sistemas públicos universais de saúde. A compreensão dos projetos em disputa no cenário internacional é fundamental para identificar possibilidades e ameaças à consolidação do Sistema Único de Saúde no Brasil.
Palavras-chave:
sistemas universais de saúde; cobertura universal em saúde; reformas de sistemas de saúde; direito à saúde; Sistema Único de Saúde.
Abstract:
In recent years, polarization between the proposals of universal system versus universal health coverage international has marked the international debate about universality in health. The concept of universal coverage has been disseminated by international organizations and incorporated into health system reforms in some developing countries, including in Latin America. The article explores the assumptions and strategies related to the proposal of universal health coverage. First, it contrasts the models of universal health coverage and universal health systems. Next, it contextualizes the international debate, including examples of different health systems. Finally, it discusses the implications of the proposal of universal coverage for the right to health in Brazil. The analysis of different concepts of universality and countries’ experiences shows that insurance-based models, either social or private, do not meet the strengths of public universal health systems. The understanding of the projects in dispute in the international arena is essential to identify possibilities and threats to the consolidation of the Unified Health System in Brazil.
Keywords:
universal health systems; universal health coverage; health reforms; right to health; Unified Health System
Universal health system and universal health coverage: Assumptions and strategies.
Resumo (abstract):
In recent years, polarization between the proposals of universal system versus universal health coverage international has marked the international debate about universality in health. The concept of universal coverage has been disseminated by international organizations and incorporated into health system reforms in some developing countries, including in Latin America. The article explores the assumptions and strategies related to the proposal of universal health coverage. First, it contrasts the models of universal health coverage and universal health systems. Next, it contextualizes the international debate, including examples of different health systems. Finally, it discusses the implications of the proposal of universal coverage for the right to health in Brazil. The analysis of different concepts of universality and countries’ experiences shows that insurance-based models, either social or private, do not meet the strengths of public universal health systems. The understanding of the projects in dispute in the international arena is essential to identify possibilities and threats to the consolidation of the Unified Health System in Brazil.
Palavras-chave (keywords):
universal health systems; universal health coverage; health reforms; right to health; Unified Health System
