The author has the intention to propose to the Brazilian health care management and sanitary reform managers an examination and positioning on the course of action in the implementation of SUS (Brazilian National Health System). The findings underscore two non-convergent set of policies that have affected the course of action in the implementation of the SUS in the 1990s: the first and 'main' course of action derives from policies created in 1988 in the so-called Citizen Constitution, of which the SUS is the most important achievement. The second and "additional" course of action derives from the prevailing macro-economic model and its related policies, implemented since the 1990s, besides advocating a social inclusion measure while leaving out all the related improvements of SUS such as Universality, Integrity and Equity. In addition, the second course of action is in opposition to the model based on social protection, besides raising the importance of market-based individualistic values and actions in general, it carries them into the health care system. The author suggests that a clarification on the desirable and on the deviant courses of action of SUS may be a vital contribution to guaranteeing social rights in health care, while preserving its integrity, equity and universal nature.
SUS, política pública de Estado: seu desenvolvimento instituído e instituinte e a busca de saídasThe Brazilian Unified Health System (SUS), State Public Policy: Its institutionalized and future development and the search for solutions
In this text, we refer to the solid and historical civilizational roots of the Brazilian Unified Health System, SUS (Sistema Único de Saúde) that give it a perennial status. Data and analyses are systematized, pointing out, in parallel to the construction of SUS, the construction of another public health policy that has subverted the principles and guidelines of the Federal Constitution of 1988: a real, implicit and hegemonic policy. As for SUS, we identify and reinforce explicit advances and resistances with its principles and guidelines, over this 30 year period, but with invaluable accumulation in management, evaluation, knowledge construction, appropriate technologies, resistance strategies and politicization in defense of the constitutional directives. The knowledge that has been acquired over this time is understood to form part of a drive towards a civilizing pathway that was proposed by the 1988 Constitution. Although SUS is considered to be an unfinished work with deviations, and the need, on one hand, to be consolidated in better achievements, and on the other, to be permanently reinvented in order to accomplish its mission.
A necessidade de planejar o número, o perfil e a distribuição da força de trabalho do setor saúde tem sido uma das grandes preocupações dos gestores, trabalhadores e usuários envolvidos na reforma sanitária brasileira, desde a concepção do Sistema Único de Saúde. Este estudo bibliográfico e documental apresenta uma análise da trajetória histórica das políticas de planejamento da força de trabalho em saúde no Brasil, destacando a recrudescência de problemas identificados desde a década de 1970 nessa área, em grande medida, pela manutenção de um modelo assistencial que privilegia os interesses privados em detrimento das necessidades e dos direitos da população.
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