Objectives: To take elements of analysis from the economic reproduction of capitalist societies\u27 frame and to discuss the changes in the process of accumulation of capital in the Brazilian health sector

Andreazzi, M F

Kornis, G D

English

University of New Mexico

University of New Mexico
UNM Digital Repository
English Latin American Social Medicine
11-10-2009
Patterns of Sectoral Accumulation: Economy and
Services in Contemporary Transformations of
Health
M F. Andreazzi
G D. Kornis
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Recommended Citation
Andreazzi, M F. and G D. Kornis. "Patterns of Sectoral Accumulation: Economy and Services in Contemporary Transformations of
Health." (2009). https://digitalrepository.unm.edu/lasm_cucs_en/38
Documento CUCS # 1C 
 
C&SC13(5) 20008Andreazzi (B) 
 
Andreazzi MF, Kornis GD. Padrões de acumulação setorial: finanças e serviços nas 
transformações contemporâneas de saúde. [Patterns of Sectoral Accumulation: 
Economy and Services in Contemporary Transformations of Health]. Ciencia & 
Saúde Coletiva (Río de Janeiro, Brasil) 2008 Septiembre-Octubre; 13(5): 1409-1420. 
Objectives: To take elements of analysis from the economic reproduction of capitalist 
societies’ frame and to discuss the changes in the process of accumulation of capital in the 
Brazilian health sector.  
Methodology: Descriptive and analytical.  
Results: To the authors both the “hypertrophy” of finances linked to the globalization of 
capital and the creation of the industrial medical complex generate changes in the process 
of accumulation of capital in the public health care sector and in the related process of 
production of goods and services. The authors describe four transformations in the 
American health care system: 1) increased costs and expenditures on health; 2) private 
funding; 3) the growth of the medical business, coupled with economic inflation; and 4) the 
creation of “Managed Care Organizations.” In contrast, the authors note two changes in 
Brazil: 1) the reduction of costs through the interaction of industrial, services and training 
sectors; and 2) a series of technological innovations (including vaccines, more effective 
medicines, smaller and less expensive biomedical equipment, diagnostic techniques and 
less invasive therapies, health promotion, fusion of international pharmaceutical 
companies, creation of individual accounts, the increase of multinational health agencies, 
and more investment of international capital). 
There are four propositions of the Marxist conceptual approach on which the authors say 
these transformations are based. First, globalization concentrates capital in industrialized 
countries, which favors companies’ control of the production of goods, services and sales. 
Second, capitalism introduces changes in the tertiary sector (franchises and insurance 
activities, many developed as small and medium enterprises) in order to provide services 
under the market dynamics and to subordinate to transnational corporations. Third, with 
influences from theories of French thought,  the authors propose that both large enterprises 
and tertiary sectors generate high production but low provision of services, and that the 
industrial medical complex controls consumption, production and sales. Fourth, with the 
contribution of neo-Marxism, the authors show that information technology is highly useful 
for coordinating global networks of production and exerting control over them.  
In this way, the authors identify six outcomes within the specific process of reproduction of 
capitalism in Brazil. 1) the increase in commercial capital as measure for lowering interest 
rates; 2) the reduction of interest rates on the production and circulation of goods thanks to 
the investment of new capital; 3) the elimination of producers of intermediate services; 4) 
the establishment of contracts between industry and insurance companies; 5) the increase 
of commercial capital through the use of both investment and pension funds; 6) the 
recognition of a health production complex as a way for increasing research and 
technological innovations.  
Conclusions: For the authors, the financing and growth of industrial medical complexes 
are central elements in the accumulation of capital in the health sector. They conclude that 
the current transformations of accumulation in the health sector generate simultaneous, 
conflictive and complementary relationships within the medical-industrial-financial 
partnership. 


Patterns of Sectoral Accumulation: Economy and Services in Contemporary Transformations of Health

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Patterns of Sectoral Accumulation: Economy and Services in Contemporary Transformations of Health

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