Gadelha Carlos Augusto Grabois
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2022 Aug 26;38Suppl 2(Suppl 2):e00263321. doi: 10.1590/0102-311X00263321. eCollection 2022.
The article aims to make a theoretical and political discussion of the concept of the Health Economic-Industrial Complex (CEIS), updating the concept to a contemporary context of technological transformation and of challenges for universal health systems, particular the Brazilian Unified National Health System (SUS). In a context of asymmetric globalization, of emergence of a technological revolution, and of the (re)placement of structural barriers that keeps Brazilian society in its historical movement of inequality, vulnerability, and exclusion, we need to rethink healthcare by resuming and updating an agenda that privileges the historical-structural factors of Brazilian society, the international insertion of the country, and its relationship with an extremely asymmetric diffusion of technical progress, knowledge, and learning, dissociated from local social and environmental needs. With a methodology that involves the analysis of the brazilian response to COVID-19, the commercial balance of the CEIS, and the access to COVID-19 vaccines, the study shows that health is a central part of the economic and social structure and reproduces the characteristics of the national development pattern within it. An equitable society, with quality of life, committed to social rights and the environment is structurally conditioned by the existence of an economic and material basis that supports it. This systemic and dialectical view is the main theoretical and political contribution intended by our study, which seeks to contribute to a collective health approach integrated with a political economy view.
本文旨在对健康经济产业综合体(CEIS)的概念进行理论和政治讨论,将这一概念更新至技术变革以及全民健康系统面临挑战的当代背景下,尤其是巴西统一国家卫生系统(SUS)。在不对称全球化、技术革命兴起以及(重新)消除使巴西社会处于不平等、脆弱性和排斥历史进程中的结构性障碍的背景下,我们需要通过恢复和更新一项议程来重新思考医疗保健问题,该议程优先考虑巴西社会的历史结构因素、该国的国际融入情况,以及其与技术进步、知识和学习的极不对称传播之间的关系,这种传播与当地社会和环境需求相脱节。通过一种涉及分析巴西对新冠疫情的应对、CEIS的商业平衡以及新冠疫苗获取情况的方法,该研究表明,健康是经济和社会结构的核心部分,并在其中重现了国家发展模式的特征。一个公平的、有生活质量的、致力于社会权利和环境保护的社会,在结构上取决于支持它的经济和物质基础的存在。这种系统性和辩证性的观点是我们研究的主要理论和政治贡献,该研究旨在为一种与政治经济学观点相结合的集体健康方法做出贡献。