Pandemia nas favelas: entre carências e potências

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Reshaping health care in Latin America : a comparative analysis of health care reform in Argentina, Brazil, and Mexico

The possibility of designing and implementing a reform proposal will depend on previously existing characteristics of the social protection system, including the health care system and social security in each country. The three countries in this comparative analysis (Argentina, Brazil and Mexico) fall into different categories according to the patterns adopted to institutionalize social protection prior to the reforms of the last two decades. Comparing health expenditures and health outcomes of each country shows a positive correlation between public expenditure and positive health indicators. Not surprisingly, Argentina has the best outcomes, both in terms of access to health services and quality of life

Derechos sociales: difíciles de construir, fáciles de destruir

The purpose of this article is to reflect on contemporary tensions between the social protection system in Brazil – which in the past 30 years has come to be organized as a social right and has been part of the construction of democracy in the country – and the current process of its dismantling under an authoritarian populist regime. From the theoretical perspective adopted in this article, structural characteristics and circumstantial factors are examined in order to explain the difficulties that have been faced in constructing a legal and institutional architecture for social rights, and on the other hand, why at present it is so easy to destroy it in practice.El objetivo de este trabajo es reflexionar, desde el caso de Brasil, sobre las tensiones actuales entre el sistema de protección social –que en los últimos 30 años se organizó como derechos de la ciudadanía y como parte de la construcción de la democracia en el país– y el proceso de desmantelamiento en el período actual por un régimen populista autoritario. Desde la perspectiva teórica presente en este trabajo, se indaga sobre las características estructurales y los factores de la coyuntura que nos permiten explicar por qué ha sido tan difícil la construcción de la arquitectura legal e institucional de los derechos sociales y, al revés, por qué resulta tan fácil en la actualidad destrozarla en la práctica

Iniquities in health policies: the Latin American case

Four points relating to the iniquities of the health services are brought out. In the first, the economic crisis the region has been going through during recent decades, is discussed and the contention that the tendency to an overall improvement of the living conditions has not been deeply affected by this crisis is questioned. In the second the characteristics of the Latin-American process of development, marked by the deenpeing of iniquities is examined. In the third an analysis of the pattern of social protection in the region is presented and in the last two polar models for the reformation of this pattern are discussed.São abordados quatro pontos sobre iniquidades nas políticas de saúde: no primeiro deles, discute-se a crise econômica atravessada pela região nas últimas décadas e problematiza-se o fato de a tendência à melhoria global do nível de vida não tenha sido profundamente afetada pela crise; no segundo ponto, discute-se as características do processo de desenvolvimento latino-americano, que tem sido marcado pelo aprofundamento das iniquidades; no terceiro, apresenta-se uma análise do padrão de proteção social na região para, no último ponto, discutir dois modelos polares de reforma deste padrão

Custeio do direito à saúde: em busca da mesma proteção constitucional conquistada pelo direito à educação = Financing the right to health: searching for the same constitutional protection achieved by the right to education

- Volume e número errados no rodapé do documento. Onde se lê: v. 12, n. 3, leia-se: v. 13, n. 1

El proceso de reformas del Seguro Social de la Enfermedad de Alemania durante la década del ‘90: avances e impasses

This article describes the process of health care reform in Germany during the ‘90s which was organized based on corporate interests. We also analyze the impact of the reform on system performance. The results are based on a review of the literature on health care systems. The analysis was based on the methodology proposed by Evans focusing on three dimensions: organization and management, financing, and health care delivery. The analysis suggests that, despite the rigidity of social protection systems based on corporatate interests, it is possible to make changes that result in positive outcomes in terms of efficacy and efficiency. The article also suggests that this process can produce negative effects on equity and population coverage.En este artículo se describen las reformas del Seguro Social de la Enfermedad de Alemania realizadas durante la década del ‘90, organizadas en base a una representación corporativa de intereses, y se analizan los impactos sobre la performance de este sistema de salud. Para la descripción del sistema y el análisis de las reformas, se realizó una investigación bibliográfica y se aplicó la metodología de abordaje integrado de las dimensiones de Organización y Gestión, Financiamiento y Atención y Provisión basada en Evans. Los análisis sugieren que, no obstante la rigidez de los sistemas de seguro social organizados sobre bases corporativas, es posible imprimir transformaciones con resultados positivos con relación a la eficacia y a la eficiencia, aunque podrían darse, a la vez, efectos negativos sobre la equidad y la expansión de la cobertura poblacional