Senna Mônica de Castro Maia
Departamento de Serviço Social, Universidade Federal Fluminense, São Gonçalo, RJ, 24210-020, Brasil.
Cad Saude Publica. 2002;18 Suppl:203-11. Epub 2003 Jan 21.
This article focuses on key elements contributing to the public social policy debate, specifically from the perspective of promoting distributive justice. The reference is the Family Health Program in Brazil and its relation to recent changes in national health policy and the literature on the issues of equity and social justice. This concern is due to recent changes in social interventions by the Brazilian state, where targeting assumes a central place in the reform process. Specifically concerning health policy, the issue of equity has gained visibility, linked to the discussion on the profile of health expenditures. One of the central aspects in this context lies in the debate between notions such as the regressive and inequitable nature of targeted measures and programs, on the one hand, and the expanded perspective of access by what have traditionally been socially excluded sectors, on the other. The debate between such perspectives highlights the controversies concerning the effectiveness of health measures, equity, and the distributive concept of social justice, with the latter as the central discussion in this study.
本文聚焦于促成公共社会政策辩论的关键要素，特别是从促进分配正义的视角。参考对象是巴西的家庭健康计划及其与国家卫生政策近期变化以及公平与社会正义问题相关文献的关系。这种关注源于巴西国家近期社会干预措施的变化，其中目标定位在改革进程中占据核心地位。具体就卫生政策而言，公平问题已受到关注，这与关于卫生支出概况的讨论相关。在此背景下的一个核心方面在于这样一些观念之间的辩论：一方面是有针对性措施和项目的递减性及不公平性，另一方面是传统上被社会排斥部门扩大了的获取机会视角。这些视角之间的辩论凸显了有关卫生措施的有效性、公平性以及社会正义分配概念的争议，其中后者是本研究的核心讨论内容。
