Obstacles to SUS universalization: tax expenditures, labor union demands and health insurance state subsidy
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10316/96299 https://doi.org/10.1590/1413-81232021266.22602019 |
Resumo: | In the light of the comparative analysis of health systems, we discuss three strategic phenomena for the SUS universalization, as follows: a) health tax expenditures; b) State funding of private plans for public servants; and c) trade union's demand for private health plans. Among the ideal types of health systems, SUS is universal in law, but hybrid in practice: Beveridgian in primary health care (PHC) and mixed in specialized/hospital care; without really being universal (public spending is only 43% of total health expenditure). There is a massive state subsidy to the private sector, through health tax expenditures (30% of the federal health budget) and financing of private plans for public servants, which generates incoherence, segmentation of the health system and inequities. Despite the general support to the SUS, the union movements have been using private health plans in collective recruitment (76% of them), reinforcing the private sector. Reducing health tax expenditures - including state funding of servants' private plans - would significantly increase the SUS budget and facilitate articulation between health workers and trade unionists, bringing the high strength of unions closer to the long struggle for the universality of the SUS and PHC. |
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Obstacles to SUS universalization: tax expenditures, labor union demands and health insurance state subsidyHealth systemsHealth policyHealthcare financingUnified health systemHealth inequalitiesHumansLabor UnionsPrivate SectorHealth ExpendituresInsurance, HealthIn the light of the comparative analysis of health systems, we discuss three strategic phenomena for the SUS universalization, as follows: a) health tax expenditures; b) State funding of private plans for public servants; and c) trade union's demand for private health plans. Among the ideal types of health systems, SUS is universal in law, but hybrid in practice: Beveridgian in primary health care (PHC) and mixed in specialized/hospital care; without really being universal (public spending is only 43% of total health expenditure). There is a massive state subsidy to the private sector, through health tax expenditures (30% of the federal health budget) and financing of private plans for public servants, which generates incoherence, segmentation of the health system and inequities. Despite the general support to the SUS, the union movements have been using private health plans in collective recruitment (76% of them), reinforcing the private sector. Reducing health tax expenditures - including state funding of servants' private plans - would significantly increase the SUS budget and facilitate articulation between health workers and trade unionists, bringing the high strength of unions closer to the long struggle for the universality of the SUS and PHC.ABRASCO2021info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://hdl.handle.net/10316/96299http://hdl.handle.net/10316/96299https://doi.org/10.1590/1413-81232021266.22602019eng1678-45611413-812334231742WOS:000669559200030https://doi.org/10.1590/1413-81232021266.22602019Tesser, Charles DalcanaleSerapioni, Mauroinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-08-11T16:31:00Zoai:estudogeral.uc.pt:10316/96299Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:14:35.490268Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Obstacles to SUS universalization: tax expenditures, labor union demands and health insurance state subsidy |
title |
Obstacles to SUS universalization: tax expenditures, labor union demands and health insurance state subsidy |
spellingShingle |
Obstacles to SUS universalization: tax expenditures, labor union demands and health insurance state subsidy Tesser, Charles Dalcanale Health systems Health policy Healthcare financing Unified health system Health inequalities Humans Labor Unions Private Sector Health Expenditures Insurance, Health |
title_short |
Obstacles to SUS universalization: tax expenditures, labor union demands and health insurance state subsidy |
title_full |
Obstacles to SUS universalization: tax expenditures, labor union demands and health insurance state subsidy |
title_fullStr |
Obstacles to SUS universalization: tax expenditures, labor union demands and health insurance state subsidy |
title_full_unstemmed |
Obstacles to SUS universalization: tax expenditures, labor union demands and health insurance state subsidy |
title_sort |
Obstacles to SUS universalization: tax expenditures, labor union demands and health insurance state subsidy |
author |
Tesser, Charles Dalcanale |
author_facet |
Tesser, Charles Dalcanale Serapioni, Mauro |
author_role |
author |
author2 |
Serapioni, Mauro |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Tesser, Charles Dalcanale Serapioni, Mauro |
dc.subject.por.fl_str_mv |
Health systems Health policy Healthcare financing Unified health system Health inequalities Humans Labor Unions Private Sector Health Expenditures Insurance, Health |
topic |
Health systems Health policy Healthcare financing Unified health system Health inequalities Humans Labor Unions Private Sector Health Expenditures Insurance, Health |
description |
In the light of the comparative analysis of health systems, we discuss three strategic phenomena for the SUS universalization, as follows: a) health tax expenditures; b) State funding of private plans for public servants; and c) trade union's demand for private health plans. Among the ideal types of health systems, SUS is universal in law, but hybrid in practice: Beveridgian in primary health care (PHC) and mixed in specialized/hospital care; without really being universal (public spending is only 43% of total health expenditure). There is a massive state subsidy to the private sector, through health tax expenditures (30% of the federal health budget) and financing of private plans for public servants, which generates incoherence, segmentation of the health system and inequities. Despite the general support to the SUS, the union movements have been using private health plans in collective recruitment (76% of them), reinforcing the private sector. Reducing health tax expenditures - including state funding of servants' private plans - would significantly increase the SUS budget and facilitate articulation between health workers and trade unionists, bringing the high strength of unions closer to the long struggle for the universality of the SUS and PHC. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10316/96299 http://hdl.handle.net/10316/96299 https://doi.org/10.1590/1413-81232021266.22602019 |
url |
http://hdl.handle.net/10316/96299 https://doi.org/10.1590/1413-81232021266.22602019 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
1678-4561 1413-8123 34231742 WOS:000669559200030 https://doi.org/10.1590/1413-81232021266.22602019 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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ABRASCO |
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ABRASCO |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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