O presente artigo faz um balanço do SUS a partir da Constituição da República de 1988, a qual incluiu dentre suas normas, o direito à saúde. Analisa-se a organização administrativa e sanitária do SUS, como o seu financiamento; as questões federativas, principalmente o papel do município na Federação, bem como a centralização na União de competências legislativas, fato que enfraquece o Estado-membro e permite a política do compadrio; e outros aspectos relevantes; o não desenvolvimento dos municípios, tornando-os dependentes das transferências de recursos da União são examinadas à luz de sua afetação à execução das políticas públicas. Outras questões como, a regionalização, o planejamento insuficiente, o centralismo federal sanitário, as relações Ministério da Saúde-município, que retardam a coordenação regional do sistema de saúde pelo Estado, algumas propostas de melhor execução e efetivação das políticas estruturantes do SUS, que devem estar definidas em lei e não em portarias, são objeto do artigo que se fixou nos principais aspectos do SUS nos últimos 30 anos.
Palavras-chave:
SUS; federalismo; financiamento.
Abstract:
This article takes stock of SUSthe Constitution of the Republic of 1988, which included among its norms, the right to health. It analyzes the administrative and sanitary organization of the SUS, as its financing; the federal issues, especially the role of the municipality in the Federation, and the centralization of the Union in the field of legislative powers, which weakens the Member State; and other relevant aspects. Non-development of municipalities, making them dependent on transfers of Union resources are examined in the light of the impact of the implementation of public policies. Other issues such as regionalization, insufficient planning, federal health centralism, Ministry of Health-municipality relations, which delay the regional coordination of the health system by the State and final considerations as proposals for better execution and implementation of the structuring policies of the SUS, defined in law and not in ordinances, are the object of the article that was established in the main aspects of the SUS in the last 30 years.
This article takes stock of SUSthe Constitution of the Republic of 1988, which included among its norms, the right to health. It analyzes the administrative and sanitary organization of the SUS, as its financing; the federal issues, especially the role of the municipality in the Federation, and the centralization of the Union in the field of legislative powers, which weakens the Member State; and other relevant aspects. Non-development of municipalities, making them dependent on transfers of Union resources are examined in the light of the impact of the implementation of public policies. Other issues such as regionalization, insufficient planning, federal health centralism, Ministry of Health-municipality relations, which delay the regional coordination of the health system by the State and final considerations as proposals for better execution and implementation of the structuring policies of the SUS, defined in law and not in ordinances, are the object of the article that was established in the main aspects of the SUS in the last 30 years.
