Takahashi Mara Alice Batista Conti, Iguti Aparecida Mari
Centro de Referência em Saúde do Trabalhador de Piracicaba, Piracicaba, Brasil.
Cad Saude Publica. 2008 Nov;24(11):2661-70. doi: 10.1590/s0102-311x2008001100021.
This article describes the changes in workers' rehabilitation practices under the Brazilian National Social Security Institute (INSS) in the 1990s, in the context of neoliberal economic adjustment measures, based on an analysis of INSS documents from 1992 to 1997. The INSS plan for "modernization" of workers' rehabilitation led to: (1) dismantling of multidisciplinary teams; (2) induction of workers to accept proportional retirement pensions and voluntary layoffs; (3) under-utilization of the remaining INSS professional staff; (4) elimination of treatment programs for workers' rehabilitation; and (5) dismantling of INSS rehabilitation centers and clinics. The changes in the Brazilian social security system undermined the county's social security project and hegemony and reduced social security reform to a mere management and fiscal issue. Current "rehabilitation" falls far short of the institution's original purpose of social protection for workers, while aiming at economic regulation of the system to contain costs of workers' benefits. Workers that suffer work-related accidents are denied occupational rehabilitation, which aggravates their social disadvantage when they return to work.
本文基于对巴西国家社会保障局(INSS)1992年至1997年文件的分析,描述了20世纪90年代在新自由主义经济调整措施背景下,INSS所进行的工人康复实践的变化。INSS的工人康复“现代化”计划导致了:(1)多学科团队的解散;(2)引导工人接受比例退休金和自愿裁员;(3)对INSS剩余专业人员的利用不足;(4)取消工人康复治疗项目;(5)拆除INSS康复中心和诊所。巴西社会保障体系的这些变化破坏了该国的社会保障项目和霸权,并将社会保障改革沦为单纯的管理和财政问题。当前的“康复”远未达到该机构最初为工人提供社会保护的目的,而是旨在对该体系进行经济调控以控制工人福利成本。遭受工伤的工人被剥夺职业康复机会,这加剧了他们重返工作岗位时的社会劣势。