Concepts and ideas concerning universal health care: results of the intergovernmental arrangement in Greater Metropolitan Buenos Aires, Argentina, from 2003 to 2011
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Tipo de documento: | Artigo |
Idioma: | spa |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8479 |
Resumo: | In the context of a federal and highly fragmented institutional framework like that Argentina, the article analyzes the concepts and ideas on which government actors organize their health policy instruments at three different levels of government. Based on this focus, the article investigates the convergences, divergences, and tensions permeating the exercising of the right to health. The analysis is organized in three dimensions of universal care that became challenges for the national policy during the period in question: ease of access to services, insured coverage, and a guaranteed set of explicit benefits for the entire population. Concerning these challenges, the actors deconstruct and reconstruct the meaning of the policies for universal health care, based on the issues on their agendas, the ideas existing prior to the programs (and based on which the changes are conceived), and the political logic by which their decisions are made. This perspective seeks to transcend the programs’ underlying technical ideas in order to capture the political dimension of their implementation, seen as a complex social construction, which also faces structural problems that are part of the agenda at each level of government in relation to health services provision. |
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Concepts and ideas concerning universal health care: results of the intergovernmental arrangement in Greater Metropolitan Buenos Aires, Argentina, from 2003 to 2011Nociones e ideas en torno al universalismo en salud: derivas en la trama intergubernamental del Gran Buenos Aires (Argentina) entre 2003 y 2011Noções e ideias em torno ao universalismo em saúde: derivas na trama intergovernamental da Grande Buenos Aires, Argentina, entre 2003 e 2011Política de SaludAcceso Universal a los Servicios de SaludFederalismoIn the context of a federal and highly fragmented institutional framework like that Argentina, the article analyzes the concepts and ideas on which government actors organize their health policy instruments at three different levels of government. Based on this focus, the article investigates the convergences, divergences, and tensions permeating the exercising of the right to health. The analysis is organized in three dimensions of universal care that became challenges for the national policy during the period in question: ease of access to services, insured coverage, and a guaranteed set of explicit benefits for the entire population. Concerning these challenges, the actors deconstruct and reconstruct the meaning of the policies for universal health care, based on the issues on their agendas, the ideas existing prior to the programs (and based on which the changes are conceived), and the political logic by which their decisions are made. This perspective seeks to transcend the programs’ underlying technical ideas in order to capture the political dimension of their implementation, seen as a complex social construction, which also faces structural problems that are part of the agenda at each level of government in relation to health services provision.En el contexto del marco institucional federal y fuertemente fragmentado de Argentina, este artículo analiza las nociones e ideas que los actores gubernamentales organizan alrededor de los instrumentos de política sanitaria en los tres niveles de gobierno diferenciados. A partir de este enfoque, se pretende indagar acerca de las convergencias, divergencias y tensiones que atraviesan el ejercicio del derecho a la salud. El análisis se organiza en tres dimensiones del universalismo que se convirtieron en desafíos de la política nacional durante el período analizado: facilitación en el acceso a los servicios, aseguramiento de la cobertura y garantía de un conjunto de beneficios explícitos para toda la población. En torno a estos desafíos, los actores deconstruyen y reconstruyen el significado de las políticas orientadas a la universalidad en salud, según los problemas que forman parte de su agenda, las ideas previas a la llegada de los programas (y a partir de las cuales conciben los cambios) y la lógica política a través de la que viabilizan sus decisiones. Esta perspectiva busca transcender las nociones técnicas que justifican los programas, con el fin de captar la dimensión política de la implementación, entendida como una construcción social compleja, que enfrenta también problemas estructurales que componen la agenda en cada nivel de gobierno, en relación a la provisión de servicios de salud.No contexto de um órgão institucional federal e fortemente fragmentado como a Argentina, este artigo analisa as noções e ideias sobre as quais os atores governamentais organizam ao redor seus instrumentos de política sanitária em três níveis de governo diferenciados. A partir desta abordagem, foi feita uma pesquisa sobre as convergências, divergências e tensões que atravessam as tentativas de mudanças, orientadas ao restabelecimento de condições mais igualitárias no exercício do direito à saúde. A análise foi organizada em três dimensões de universalidade que foram convertidas em desafios da política nacional durante o período analisado: facilitação no acesso aos serviços, garantia de cobertura, além de um conjunto de benefícios explícitos para toda a população. Em torno desses desafios, os atores desconstroem e reconstroem o significado das políticas orientadas pela universalidade em saúde, segundo os problemas que fazem parte da agenda deles, as ideias prévias com a chegada dos programas (e a partir das quais concebem as mudanças) e a lógica política através da qual viabilizam as decisões deles. Esta perspectiva procura transcender as noções técnicas que justificam os programas, a fim de obter a dimensão política da implementação, entendida como uma construção social complexa, que faz frente também a problemas estruturais que compõem a agenda em cada nível de governo, em relação a provisão de serviços de saúde.Reports in Public HealthCadernos de Saúde Pública2018-11-08info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/847910.1590/0102-311x00002018Reports in Public Health; Vol. 34 No. 11 (2018): NovemberCadernos de Saúde Pública; v. 34 n. 11 (2018): Novembro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZspahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8479/18900https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8479/18901Copyright (c) 2018 Cadernos de Saúde Públicainfo:eu-repo/semantics/openAccessMagdalena Chiara2024-03-06T15:30:35Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/8479Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:09:39.620332Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
Concepts and ideas concerning universal health care: results of the intergovernmental arrangement in Greater Metropolitan Buenos Aires, Argentina, from 2003 to 2011 Nociones e ideas en torno al universalismo en salud: derivas en la trama intergubernamental del Gran Buenos Aires (Argentina) entre 2003 y 2011 Noções e ideias em torno ao universalismo em saúde: derivas na trama intergovernamental da Grande Buenos Aires, Argentina, entre 2003 e 2011 |
title |
Concepts and ideas concerning universal health care: results of the intergovernmental arrangement in Greater Metropolitan Buenos Aires, Argentina, from 2003 to 2011 |
spellingShingle |
Concepts and ideas concerning universal health care: results of the intergovernmental arrangement in Greater Metropolitan Buenos Aires, Argentina, from 2003 to 2011 Magdalena Chiara Política de Salud Acceso Universal a los Servicios de Salud Federalismo |
title_short |
Concepts and ideas concerning universal health care: results of the intergovernmental arrangement in Greater Metropolitan Buenos Aires, Argentina, from 2003 to 2011 |
title_full |
Concepts and ideas concerning universal health care: results of the intergovernmental arrangement in Greater Metropolitan Buenos Aires, Argentina, from 2003 to 2011 |
title_fullStr |
Concepts and ideas concerning universal health care: results of the intergovernmental arrangement in Greater Metropolitan Buenos Aires, Argentina, from 2003 to 2011 |
title_full_unstemmed |
Concepts and ideas concerning universal health care: results of the intergovernmental arrangement in Greater Metropolitan Buenos Aires, Argentina, from 2003 to 2011 |
title_sort |
Concepts and ideas concerning universal health care: results of the intergovernmental arrangement in Greater Metropolitan Buenos Aires, Argentina, from 2003 to 2011 |
author |
Magdalena Chiara |
author_facet |
Magdalena Chiara |
author_role |
author |
dc.contributor.author.fl_str_mv |
Magdalena Chiara |
dc.subject.por.fl_str_mv |
Política de Salud Acceso Universal a los Servicios de Salud Federalismo |
topic |
Política de Salud Acceso Universal a los Servicios de Salud Federalismo |
description |
In the context of a federal and highly fragmented institutional framework like that Argentina, the article analyzes the concepts and ideas on which government actors organize their health policy instruments at three different levels of government. Based on this focus, the article investigates the convergences, divergences, and tensions permeating the exercising of the right to health. The analysis is organized in three dimensions of universal care that became challenges for the national policy during the period in question: ease of access to services, insured coverage, and a guaranteed set of explicit benefits for the entire population. Concerning these challenges, the actors deconstruct and reconstruct the meaning of the policies for universal health care, based on the issues on their agendas, the ideas existing prior to the programs (and based on which the changes are conceived), and the political logic by which their decisions are made. This perspective seeks to transcend the programs’ underlying technical ideas in order to capture the political dimension of their implementation, seen as a complex social construction, which also faces structural problems that are part of the agenda at each level of government in relation to health services provision. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-11-08 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8479 10.1590/0102-311x00002018 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8479 |
identifier_str_mv |
10.1590/0102-311x00002018 |
dc.language.iso.fl_str_mv |
spa |
language |
spa |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8479/18900 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8479/18901 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2018 Cadernos de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2018 Cadernos de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 34 No. 11 (2018): November Cadernos de Saúde Pública; v. 34 n. 11 (2018): Novembro 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
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Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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1798943400055013376 |