0005/2022 - Tendência à estabilidade institucional: regulação, formação e provimento de médicos no Brasil durante o governo Lula Trend towards institutional stability: regulation, training and provision of doctors in Brazil during the Lula government
O objetivo do artigo é analisar as características da política de regulação, formação e provimento de médicos no Brasil durante os governos Lula (2003-2010) e o processo de disputa em torno de sua mudança defendida pelos dirigentes do Ministério da Saúde, integrantes do movimento sanitário. Trata-se de um estudo de caso que utilizou o process tracing como estratégia metodológica e, como fontes, documentos e entrevistas. Utilizou-se os recursos teóricos dos estudos sobre processo político e a Teoria da Mudança Institucional Gradual. Os principais resultados são a compreensão do arranjo institucional relacionado à política e a identificação de atores individuais e coletivos que atuaram para sua conservação ou mudança. Constatou-se três restrições político-institucionais à mudança: a oposição da comunidade de política ‘medicina-liberal’, que exercia influência sobre a política, a falta de apoio ou resistência do Ministério da Educação às mudanças propostas e a decisão do núcleo do governo de não levar adiante propostas que, ao mesmo tempo, tivessem que ser aprovadas no Legislativo e contassem com a oposição da ‘comunidade’ medicina-liberal. Predominou um equilíbrio que tendeu à reprodução do status quo e do arranjo institucional vigente, apesar de terem havido alterações incrementais na política.
Palavras-chave:
Recursos Humanos em Saúde; Educação Médica; Política Pública
Abstract:
This article aims to analyse the characteristics of the regulation, training and supply policies of medical doctors in Brazil, during Lula government (2003-2010), as well as the process of dispute about a policy change proposed by senior officers of the Ministry of Health, who were members of the sanitary movement. This is a case study that used process tracing as a methodological strategy and, as sources, documents and interviews. We used the theoretical resources offered by studies on political process and the Theory of Gradual Institutional Change. The main findings are the understanding of institutional arrangements in this policy, and the identification of individual and collective actors who acted to change the policy. Three political-institutional restrictions to change were found: the opposition of the liberal-medicine political community, which exerted a political influence on the area, the lack of support or resistance to changethe Ministry of Education and the government nucleus decision not to carry out proposals that, at the same time, had to be approved by the Legislative and had the opposition of the liberal-medicine community. A balance tending to reproduce the status quo and the current institutional arrangement prevailed, despite the implementation of incremental policy changes.
Keywords:
Human Resources in Health; Medical Education; Public Policy
Trend towards institutional stability: regulation, training and provision of doctors in Brazil during the Lula government
Resumo (abstract):
This article aims to analyse the characteristics of the regulation, training and supply policies of medical doctors in Brazil, during Lula government (2003-2010), as well as the process of dispute about a policy change proposed by senior officers of the Ministry of Health, who were members of the sanitary movement. This is a case study that used process tracing as a methodological strategy and, as sources, documents and interviews. We used the theoretical resources offered by studies on political process and the Theory of Gradual Institutional Change. The main findings are the understanding of institutional arrangements in this policy, and the identification of individual and collective actors who acted to change the policy. Three political-institutional restrictions to change were found: the opposition of the liberal-medicine political community, which exerted a political influence on the area, the lack of support or resistance to changethe Ministry of Education and the government nucleus decision not to carry out proposals that, at the same time, had to be approved by the Legislative and had the opposition of the liberal-medicine community. A balance tending to reproduce the status quo and the current institutional arrangement prevailed, despite the implementation of incremental policy changes.
Palavras-chave (keywords):
Human Resources in Health; Medical Education; Public Policy
Pinto, H. A., Côrtes, S. M. V.. Tendência à estabilidade institucional: regulação, formação e provimento de médicos no Brasil durante o governo Lula. Cien Saude Colet [periódico na internet] (2022/Jan). [Citado em 27/09/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/tendencia-a-estabilidade-institucional-regulacao-formacao-e-provimento-de-medicos-no-brasil-durante-o-governo-lula/18261?id=18261
