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      A crise mundial de 2008 e o golpe do capital na política de saúde no Brasil Translated title: The global crisis of 2008 and the coup of capital in Brazilian health policy

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          Abstract

          RESUMO O objetivo do artigo foi analisar a conjuntura posterior às eleições presidenciais de 2014, discutindo possíveis relações com a crise econômica mundial e com os desdobramentos do golpe de 2016 na saúde. Trata-se de um artigo de opinião que contemplou a análise dos principais fatos políticos do período. Os resultados ressaltam que a financeirização da saúde, o ajuste fiscal, a restauração do neoliberalismo e o clientelismo político da direita têm gerado o desmonte do Sistema Único de Saúde (SUS), vis-à-vis alguma resistência de frentes e movimentos sociais progressistas. Conclui-se pela necessidade de acúmulo de energias políticas para alterar a correlação de forças na atual conjuntura.

          Translated abstract

          ABSTRACT The objective of the article is to analyze the conjuncture after the 2014 presidential elections, by discussing possible connections with the global economic crisis and the unfolding of the 2016's coup d'etat in the health context. It is an opinion article that contemplated the analysis of the main political facts of the period above mentioned. The results highlight that the financialization of health, the fiscal adjustment, the restoration of neoliberalism, and the political clientelism of the right-wing political party have caused the breakdown of the SUS (Unified Health System), facing some resistance of fronts and progressive social movements. It is concluded the need for accumulation of political energies to change the correlation of forces in the current conjuncture.

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          The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain

          The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date), and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms’ impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems.
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            Universal health coverage in Latin American countries: how to improve solidarity-based schemes

            In this Health Policy we examine the association between the financing structure of health systems and universal health coverage. Latin American health systems encompass a wide range of financial sources, which translate into different solidarity-based schemes that combine contributory (payroll taxes) and non-contributory (general taxes) sources of financing. To move towards universal health coverage, solidarity-based schemes must heavily rely on countries' capacity to increase public expenditure in health. Improvement of solidarity-based schemes will need the expansion of mandatory universal insurance systems and strengthening of the public sector including increased fiscal expenditure. These actions demand a new model to integrate different sources of health-sector financing, including general tax revenue, social security contributions, and private expenditure. The extent of integration achieved among these sources will be the main determinant of solidarity and universal health coverage. The basic challenges for improvement of universal health coverage are not only to spend more on health, but also to reduce the proportion of out-of-pocket spending, which will need increased fiscal resources.
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              A Constituição Cidadã e os 25 anos do Sistema Único de Saúde

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                sdeb
                Saúde em Debate
                Saúde debate
                Centro Brasileiro de Estudos de Saúde (Rio de Janeiro, RJ, Brazil )
                0103-1104
                2358-2898
                October 2018
                : 42
                : spe2
                : 11-21
                Affiliations
                [1] Salvador Bahia orgnameUniversidade Federal da Bahia orgdiv1Instituto de Humanidades, Artes e Ciências Professor Milton Santos Brazil carment@ 123456ufba.br
                [2] Salvador Bahia orgnameUniversidade Federal da Bahia orgdiv1Instituto de Saúde Coletiva Brazil jairnil@ 123456ufba.br
                Article
                S0103-11042018000500011
                10.1590/0103-11042018s201
                9a1c8ae6-c86f-4d26-b1d3-773ba818f236

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 11 July 2018
                : 04 September 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 11
                Product

                SciELO Public Health

                Categories
                Artigo de Opinião

                Unified Health System,Health policy,Reforma dos serviços de saúde,Sistema Único de Saúde,Política de saúde,Health care reform

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