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从马克思主义依附理论视角看巴西卫生领域的国家与资本积累

[State and capital accumulation in Brazilian health from the perspective of the Marxist Dependency Theory].

作者信息

Rodrigues Paulo Henrique de Almeida, Mattos Arthur Lobo Costa, Monteiro Nercilene Santos da Silva, Silva Roberta Dorneles Ferreira da Costa, Baldo Valentina Sofía Suárez

机构信息

Instituto de Medicina Social Hésio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.

Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.

出版信息

Cad Saude Publica. 2024 Jan 8;39(12):e00082923. doi: 10.1590/0102-311XPT082923. eCollection 2024.

Abstract

The health sector is one of the major fields of economic, social, scientific, and technological development in Brazil, and has been the arena of dispute between capitalist interests that regard health as a commodity and advocates of universal access who regard health as an essential good. The Brazilian Federal Constitution of 1988 determined that health is a fundamental right and the State's responsibility, and since then the country has made progress with public policy, but has suffered setbacks and blockages due to its status as a peripheric country, historically subordinated to the interests of core countries, which see Brazil as a broad consumer market. These external interests associated with the internal bourgeoisie have been taking advantage of the Brazilian State since the 1960s, when the foundation of business groups expanded, dominating various health segments, especially since the neoliberal policies of the 1990s. These aspects are much explored in publications in Public Health, but this text seeks a new approach, using the Marxist Theory of Dependency as a reference to analyze, albeit in a preliminary way, the situation of political, economic, and technological dependence that has distanced health policy from the ideals of a public and universal system, defended in the Brazilian Health Reform.

摘要

卫生部门是巴西经济、社会、科学和技术发展的主要领域之一,一直是将健康视为商品的资本主义利益集团与主张全民可及的倡导者之间的争议领域,后者将健康视为一项基本权益。1988年巴西联邦宪法规定,健康是一项基本权利且是国家的责任,自那时起,该国在公共政策方面取得了进展,但由于其作为边缘国家的地位,历史上从属于核心国家的利益,而核心国家将巴西视为一个广阔的消费市场,因此遭受了挫折和阻碍。自20世纪60年代商业集团基础扩大以来,这些与国内资产阶级相关的外部利益集团一直在利用巴西国家,主导着各个卫生领域,尤其是自20世纪90年代新自由主义政策以来。公共卫生领域的出版物对这些方面进行了大量探讨,但本文寻求一种新的方法,以马克思主义依附理论为参考,尽管只是初步地分析政治、经济和技术依附状况,这种状况使卫生政策偏离了巴西卫生改革所捍卫的公共和全民体系的理想。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d1c/10775961/7887abf56547/1678-4464-csp-39-12-PT082923-gf1.jpg

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