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Master's Dissertation
DOI
https://doi.org/10.11606/D.6.2021.tde-18102021-092449
Document
Author
Full name
Rodrigo Meirelles
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2021
Supervisor
Committee
Ianni, Aurea Maria Zöllner (President)
Costa, Maria Izabel Sanches
Leite, Cristiane Kerches da Silva
Marques, Maria Cristina da Costa
Title in Portuguese
Interfaces entre saúde e democracia no contexto contemporâneo: dilemas entre o sucesso e a crise
Keywords in Portuguese
Acesso aos Serviços de Saúde
Democracia
Participação Social
Abstract in Portuguese
Este trabalho analisa, articuladamente, dois elementos subjacentes à questão democrática na saúde, o acesso universal e a participação social na saúde, com experiências de gestores municipais de saúde em 2019 e inícios de 2020. A tese central é a de que há uma crise no binômio saúde-democracia expressas nas questões do acesso aos serviços e da participação social na saúde e que tem, em seus aspectos originários e de expressão, as estratégias vitoriosas de implementação do projeto reformador na saúde pelo movimento sanitário ao final do século XX. Realizou-se uma pesquisa empírica, por meio de entrevistas semiestruturadas com cinco gestores locais da região do Grande ABC paulista. A análise desse material permitiu identificar que a universalização do acesso tem se materializado nos municípios em estudo pelo aumento substancial do consumo individual dos serviços médico-assistenciais e a radicalização de sua expansão culmina em um amplo processo de medicalização da sociedade. No caso da participação social na saúde, identificou-se que, no âmbito dos Conselhos de Saúde, desenvolve-se uma exercício participativo pobre em inovação social e esvaziado politicamente, o que revela as características históricas da primazia do Estado na formulação da política de saúde, bem como expressa as marcas do gerencialismo e da lógica do mercado características das sociedades capitalistas contemporâneas. Identificou-se, entretanto, que concomitantemente a esse processo, os municípios experienciam a emergência de novas formas de participação social por meio das tecnologias de informação e de comunicação, com publicações e manifestações dos indivíduos nas redes sociais. O conteúdo das publicações é imprevisível para a gestão pública e seus efeitos são impostos de maneira imediata na realidade virtual assim que as postagens são realizadas, ultrapassando os limites do espaço e do tempo das atividades governamentais clássicas.
Title in English
Interfaces between health and democracy in the contemporary context: dilemmas between success and crisis
Keywords in English
Access to Health Services
Democracy
Social Participation
Abstract in English
This work articulates the analysis of two elements of the relation between health and democracy, which are the universal access and the social participation in health, with experiences of municipal health managers in 2019 and 2020. The central thesis adopted is that there is a crisis in the health-democracy binomial expressed in the issues of access and participation and which has, as one of its points of origin and expression, the successful strategies for implementing the health reform project by the sanitary movement at the end of the 20th century. The work is based on empirical research realized by semi-structured interviews with five local health managers in the ABC region of São Paulo. From the interviews, it was identified that the universalization of access has materialized in the municipalities due to the substantial increase in individual consumption of medical care services, in its most positive sense, and the radicalization of its expansion culminates in a broad process of medicalization of society. In the case of social participation in health, it was identified that, within the scope of the Health Councils, a participatory exercise is poor in social innovation and politically emptied, which highlights the historical characteristics of the primacy of the State in the formulation of health policy, while expressing the marks of managerialism and market logic that are characteristic of contemporary capitalist societies. Concomitantly, the municipalities has experienced a emergence of new forms of social participation through information and communication Technologies by publications and expressions of individuals on social networks. The content of the publications is unpredictable for public management, exceeding the limits of space and time of classic government activities.
 
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MeirellesR_MTR_O.pdf (1.59 Mbytes)
Publishing Date
2021-10-18
 
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