Dados é uma das principais e mais longevas publicações nas ciências sociais no Brasil. Criada em 1966, divulga trabalhos inéditos e inovadores, oriundos de pesquisa acadêmica, de autores brasileiros e estrangeiros. Editada pelo IESP-UERJ, é seu objetivo conciliar o rigor científico e a excelência acadêmica com ênfase no debate público a partir da análise de questões substantivas da sociedade e da política.
Dados vol. 33 n. 2 Rio de Janeiro 1990
Resumo
The reform process that took place within the Brazilian health care system during the eighties is examined from a comparative angle. The central thesis is that the system's structural evolution seems to have been more symptomatic of a residual than of a universal format, despite the publicizing intentions of the proponents of the Sanitary Reform. The better-paid sectors of society (the middle classes, including laborers within dynamic sectors) have gradually abandoned the public health sub-system, becoming patrons of the private sub-system. This shift was made possible by the appearance and growth of financing mechanisms (health insurance, group medical plans, etc.) that foster an increase in the financial autonomy of the private sector in relation to the public. Thus, although the Brazilian Sanitary Reform model took its inspiration from the British system (i.e., universal access, with services offered predominantly by the public sector), the Brazilian system has taken on features of the US system, where state action is residual and reaches only those groups that are incapable of obtaining access to private health care services via the marketplace.
A Universalização Excludente: Reflexões sobre as Tendências do Sistema de Saúde
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