Laurell Asa Ebba Cristina
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Rev Lat Am Enfermagem. 2016;24:e2668. doi: 10.1590/1518-8345.1074.2668. Epub 2016 Mar 4.
This article analyzes the content and outcome of ongoing health reforms in Latin America: Universal Health Coverage with Health Insurance, and the Universal and Public Health Systems. It aims to compare and contrast the conceptual framework and practice of each and verify their concrete results regarding the guarantee of the right to health and access to required services. It identifies a direct relationship between the development model and the type of reform. The neoclassical-neoliberal model has succeeded in converting health into a field of privatized profits, but has failed to guarantee the right to health and access to services, which has discredited the governments. The reform of the progressive governments has succeeded in expanding access to services and ensuring the right to health, but faces difficulties and tensions related to the permanence of a powerful, private, industrial-insurance medical complex and persistence of the ideologies about medicalized 'good medicine'. Based on these findings, some strategies to strengthen unique and supportive public health systems are proposed.
医疗保险覆盖下的全民健康覆盖以及全民公共卫生系统。其目的是比较和对比每一项改革的概念框架与实践，并核实它们在保障健康权和获得所需服务方面的具体成果。研究确定了发展模式与改革类型之间的直接关系。新古典-新自由主义模式成功地将医疗卫生转化为一个私有化盈利领域，但未能保障健康权和服务可及性，这使政府声誉受损。进步政府的改革成功扩大了服务可及性并确保了健康权，但面临着与强大的私营工业保险医疗联合体的长期存在以及医疗化“优质医疗”观念的持续存在相关的困难和紧张关系。基于这些研究结果，本文提出了一些加强独特且具支持性的公共卫生系统的策略。
