Sus,politica publica de Estado:seu desenvolvimento instituído e instituinte e a busca de saidas

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The Brazilian Unified Health System (SUS), State Public Policy:
Its institutionalized and future development and the search for solutions

Nelson Rodrigues dos Santos 1

Departamento de Saúde
Coletiva, Faculdade de
Ciências Médicas,
Universidade Estadual de
Campinas Preventiva e
Social. Tessália Vieira de
Camargo 126, Cidade
Universitária. 13083-970
Campinas SP. [e-mail] 1

Abstract This paper redeems the significance of the health reform movement and the municipal healthcare movement in the context of the 1970s and 1980s, and its social, politic and innovative power in the democratic reconstruction of the day. It then notes that the implementation of the constitutional guidelines, regulated in 1990 by
Laws 8080/90 and 8142/90, has been characterized in the last 22 years by four major and mounting obstacles imposed by State policy on all governments: federal underfunding; federal subsidies to the private health plan market; resistance to reform of the State management structure of service provision; and the handing over of administration of public facilities to private entities. The
Brazilian Unified Health System (SUS) included half the population that was once excluded in the public health system, though these obstacles keep the coverage of primary care focused below the poverty line and with poor resolution. The conclusion drawn is that the real policy of the state for healthcare in the past 22 years has prioritized the creation and expansion of the private health plan market for consumer rights, and relegated the effectiveness of constitutional guidelines for civic human rights to second place.
Key words Trajector ies of SUS, SUS: State policy, Health policy

Resumo O texto resgata significados do movimento da reforma sanitária e do movimento municipal de saúde no contexto dos anos 70 e 80, sua força social, política e inovadora na reconstrução democrática na época. A seguir constata que a