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[没有公平的民主:巴西卫生改革及国家卫生系统十九年分析]

[Democracy without equity: analysis of health reform and nineteen years of National Health System in Brazil].

作者信息

Coelho Ivan Batista

机构信息

Núcleo de Estudos em Saúde Coletiva, UFMG, Belo Horizonte, MG.

出版信息

Cien Saude Colet. 2010 Jan;15(1):171-83. doi: 10.1590/s1413-81232010000100023.

Abstract

This paper aims to evaluate the nineteen years of the National Health System in Brazil, under the prism of equity. It takes into account the current political context in Brazil in the 80s, that the democratization of the country and the health sector could, per se, lead to a more equitable situation regarding the access to health services. Democracy and equity concepts are here discussed; analyzing which situations may facilitate or make it difficult its association in a theoretical plan, applying them to the Brazilian context in a more general form and, to emphasizing practical implications to the National Health System and to groups of activism related to health reforms. It also seeks to show the limits and possibilities of these groups with regards to the reduction of inequality, in relation to the access to health services, which still remain. To conclude, the author points out the need for other movements to be established which seek the reduction of such and other inequalities, such as access to education, housing, etc, drawing special attention to the role played by the State, which is questioned regarding its incapacity of promoting equity, once it presents itself as being powerful when approaching other matters.

摘要

本文旨在从公平的视角评估巴西国家卫生系统的十九年历程。它考虑到巴西20世纪80年代的当前政治背景,即国家和卫生部门的民主化本身可能会在获得卫生服务方面带来更公平的局面。这里讨论了民主和公平概念;分析哪些情况在理论层面可能促进或阻碍它们的关联,以更普遍的形式将其应用于巴西背景,并强调对国家卫生系统以及与卫生改革相关的激进主义团体的实际影响。它还试图展示这些团体在减少与卫生服务获取相关的不平等方面的局限性和可能性,这种不平等仍然存在。最后,作者指出需要建立其他运动来减少此类及其他不平等,如教育、住房等方面的不平等,并特别关注国家所起的作用,鉴于国家在处理其他事务时表现出强大能力,但其促进公平的能力却受到质疑。

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