O capital humano: considerações sobre o trabalho clínico em serviços de saúde suplementar à luz da psicanálise

Abstract

The current work aims to discuss, problematize and verify the challenges and difficulties concerning the clinical act guided by psychoanalysis in a health insurance company that is oriented by profit and productivity. As for the specific goals, this research looks into the political-economical models (capitalism and neoliberalism), the health policies (both public and private), the notion of health as a product and its establishment as a trade, the effects on psychological assistance provided in supplementary healthcare as well as the implications of contemporary social bonds in this matter. The work seeks to investigate what is actually offered when the main product is healthcare, a right to all citizens according to Brazilian legislation, and its appropriation of the public system (SUS) in order to favored profit. The methodology is based on bibliographical review of the legislation concerning the Brazilian healthcare system, both public and private, papers that problematize theories and practices in healthcare, psychoanalysts and philosophers that focus their work on capitalism and neoliberalism. The main theorical reference is psychoanalysis (Sigmund Freud, Jacques Lacan and others authors/commenters), as a way to reflect on the clinical act in this scenario. Once it is established the relationship between the political-economical systems and healthcare promotion in society it is possible to sustain the hypotheses that health is treated nowadays as a product and health insurance, the way to trade it. In supplementary health the imperative is profit and productivity, under the slogan of “integrative care” – taken over from the public system SUS. Thereby, a long term psychological treatment becomes impossible also by the work conditions presented to the workers that are considered replaceable in many fronts. Thus the capitalism imposition is evident, psychoanalysis is a way to sustain, reflect and deepened the psychological act, as it operates under the logic of the unconscious subject. We believe that promoting changes in managing healthcare on a daily basis by questioning the current functioning of it can change the reality of the system as well as the care offered, in a way to guarantee a personalized and singularized care.