Relação público-privado no contexto da reforma do Estado e da descentralização em saúde: o caso do setor privado de serviços de saúde vinculado ao SUS

Abstract

This dissertation attempts to evaluate some of the tendencies found in the public-private relationship within the Sisterma Único de Saúde (Unified Health System - SUS), and it focuses mainly on the analysis of several aspects of the insertion and participation of the private health care sector (SPSS) in this system since the 1990s. Given that the health sector was part and parcel of the profound changes that ocurred in the public policies since the nineties, the State Reform project and the process of descentralizattion are also analysed. Two of these changes were the descentralization process that was directly associated with the "municipalization", and the creation of new forms of participation of the private sector in the health area. The strengthening of the so-called third sector and the privatization in the health sector, within these new forms, are closely related with what became known as the publicization of the State by the neoliberal policy. The process of transformation in the public-private relationship within SUS is, therefore, a privileged object of analysis. In order to do that, we articulated the understanding of the significant participation of the SPSS in SUS with the evaluation of the administration challenges thet both the system and the health public policy face.