Political- administrative |
Along the democratization process, this period became the legitimating perspective as CFB and LOS were sanctioned. In this period, SUS was created as a social welfare element, with directives that involved decentralization, integrality and social control. SUS was launched along with NOB and Noas, Five different federal governments were elected over this period, characterized as: development-driven, with neoliberal agenda, inflationary control, specific tributes destined to the health area, normative procedures aimed at purchases and contracts, and contracts by the public power and administrative modernization. New managerial procedures were implemented as neo-developmental practices took place with privatization plans, reduction of public civil service, selectivity of social policies and social welfare reform. |
Started during the fifth post-Constituent government elected, it was characterized by continuity known as neo-developmental, socio-liberal character. Consequently, the agenda was built on inclusion, social policies and incentives for income re-distribution.Concerning administrative procedures, transparency and State control were improved and public management strategies aimed at partnerships and concessions were widened. Remarkable normative remodeling of health care procedures, specifically as to hospital care, stressing inter-sector procedures and relation between the different care levels. |
Administrative landmarks:
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Administrative landmarks:
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- CFB/1988: exposing the principles of the public administration (legality, impersonality, morality and publicity) and its configuration as either direct or indirect character (by means of autarchies and foundations); - Law #8666/1993: established norms for bids and contracts by the public administration; - EC #01/1994: created the Social Emergency Fund (FSE); - Mare/1995: a ministry was created to be responsible for the Directive Plan for Reforming the State Operational Structure (PDRAE) ;- EC #19/1998: includes the principle of efficiency in public administration; - Law #9637/1998: created OS along with the National Publicizing Program; - Law #9790/1999: created the Civil Society Organizations of Public Interest (Oscip) and the Partnership Agreement; - Law #101/2000: established public norms for fiscal management responsibility; - EC #27/2000: renaming the Emergency Social Fund (FSE) to Disentailing of the Union's resources (DRU). |
- Law #1.1079/2004: established general norms for PPP biddings and contracts in the public administration sphere; - Administrative Act #161/2010: established cooperation among public entities; - Administrative Act #1.034/2010: rules for complementary participation of either private or non-profit institutions:- Complementary Act #141/2012: rules for minimum values to be paid for health services in the government spheres; - Law #12.550/2011: creates the EBSERH; - Law #13.019/2014: creates the Organization of Civil Society (OSC);- EC #42/2003, EC #56/2007, EC #68/2011: DRU renewals. |
Legal normative landmarks of the Health Policy |
1986: VIII CNS; 1988: Created the new CFB, where health is considered a social right and a State duty, services are linked to SUS and may be either public or private, rendered as straightly public, complementary and supplementary; 1990: LOS #8080 and #8142; 1991: NOB 91; 1993: NOB 93; 1996: NOB 96; 2000: EC #29, altering articles and assuring, under the Constitution, minimum resources for financing public health actions and services; 2001: Noas 01; 2002: Noas 02; |
2003: PNAU; 2004: RAHB, PNH, PN-HPP; 2006: Health Pact; PPI-Assistance; 2008: PN-Regulation; 2009: Beneficent Entities Regulation;2010: RAS/SUS; Cooperation Agreement between Public Entities; Complementary Participation of either private or non-profit institutions; 2011: RAU/SUS; Ruling LOS; Conitec; Stork Network; Psycho-social; RDC Best Functioning Practices; Readequa PNAU, RAU, PNAB and Certification of Beneficent Entities; 2012: Attention Network for Disabled Persons; National List of Health Actions and Services; 2013: Redefine Home Care; Care Network for Chronic Diseases; Creates the PNHOSP, procedures for celebrating contracts with hospitals/SUS. |
Strategic Convergencess and/or Divergencesas |
Deliberations made between VIII CNS and XI CNS displayed important (dis)alignments regarding the PNHOSP formulation. Among alignments, stand out: organic participation of the society in SUS, decentralization from the municipalization perspective. As dis-alignments: health priority in the context of political and economic crises, changes in the hegemonic care and tripartite financing, complementarity of services characterized as public right or covenant, improvement in quality and assistance coverage, opposition to multiple forms of privatization and alternative management models, greater autonomy, inadequate follow-up tools, evaluation and regulation. |
National Health Conferences (CNS) from XII to XIV were realized. There was alignment with Brazilian Sanitary Movement, de-bureaucratization, decentralization towards regionalization, reinforcement of social welfare, pacts and tripartite financing flows, improved RHS management, wider coverage and strengthening of HPP. (Dis)alignments: tributary reform and adjustment of social responsibility, private initiative concerning financing and regulation, health as a marketable item, regulatory function and no more privatization, no more DRU and managerial procedures. |