A Agenda de (Contra) Reformas do Banco Mundial para Saúde Brasileira: Fundo Público e Ajuste Estrutural

Abstract

This research aimed to elucidate the relationship between the counter-reformist measures implemented in the context of health policy in the period between 1988 and 2018 and the notes made by the World Bank in the country's assistance documents and in documents specifically elaborated on the subject of health. To develop our study, we consider it important to analyze the central categories for understanding capitalism; the fundamentals of the crisis of capital; the Public Debt, which has been shaped as an instrument to punish the public fund and used as a justification for the implementation of “fiscal adjustment” programs; in order to understand the characteristics of the different governments instituted in the period, we sought to analyze them using their government programs as a guideline; aiming to deepen our understanding of the performance of the World Bank, we seek to review the historical process of its constitution and, finally, we seek to analyze the proposals for assistance to the country prepared by this organization for Brazil. Our analyzes indicate that, in general, all governments have incorporated the Bank's guidelines even though there are differences in the pace of this incorporation. In the area of health, it was shown that the Bank has directed the implementation of fiscal adjustments in guidelines that have occurred in the non-implementation of the public health system as established by the Federal Constitution of 1988. The Bank's guidelines have assumed the meaning of, on the one hand, to form a basic universal system focused on the poorest population and, on the other hand, to strengthen the expansion of the private sector considered a merchandise.