Universal health systems for Latin America: recent and old innovations in health services
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Data de Publicação: | 2018 |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Revista Brasileira em Promoção da Saúde |
Texto Completo: | https://ojs.unifor.br/RBPS/article/view/8779 |
Resumo: | Objective: The paper discusses the need to balance “old and recent” innovations in the construction of health systems. Data synthesis: Description of the trajectory of contemporary systems with analysis of the reforms conducted in Brazil, Chile, Colombia, Spain and Portugal. Five moments were identified: expansion of services, "democratic-rationalizing" reforms, neoliberal adjustments, pro-coordination reforms, further adjustments and the proposal of universal coverage for low- and middle-income countries. In Chile and Colombia there was the explicit introduction of private insurance and, in Brazil, the implementation of an integrated public system under fiscal financing. In these three countries, segmentation and fragmentation of services still predominate, with a complex composition of public and private services. Portugal and Spain have implemented national systems integrating "old and recent innovations", whose macro-efficiency has been demonstrated. Conclusion: In Latin America, proposals to universalize coverage without changes in the health care model pose risks of a deregulated increase in consumption, not corresponding to the health needs of the population. Knowledge and debate based on the experiences accumulated in Brazil and in the Iberian countries can contribute to coping with these challenges. |
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Universal health systems for Latin America: recent and old innovations in health servicesSistemas universales para América Latina: jóvenes y antiguas innovaciones de los servicios de saludSistemas universais para a América Latina: jovens e antigas inovações nos serviços de saúdeLatin AmericaHealth Care ReformInnovation.América LatinaReforma dos Serviços de SaúdeInovação.Objective: The paper discusses the need to balance “old and recent” innovations in the construction of health systems. Data synthesis: Description of the trajectory of contemporary systems with analysis of the reforms conducted in Brazil, Chile, Colombia, Spain and Portugal. Five moments were identified: expansion of services, "democratic-rationalizing" reforms, neoliberal adjustments, pro-coordination reforms, further adjustments and the proposal of universal coverage for low- and middle-income countries. In Chile and Colombia there was the explicit introduction of private insurance and, in Brazil, the implementation of an integrated public system under fiscal financing. In these three countries, segmentation and fragmentation of services still predominate, with a complex composition of public and private services. Portugal and Spain have implemented national systems integrating "old and recent innovations", whose macro-efficiency has been demonstrated. Conclusion: In Latin America, proposals to universalize coverage without changes in the health care model pose risks of a deregulated increase in consumption, not corresponding to the health needs of the population. Knowledge and debate based on the experiences accumulated in Brazil and in the Iberian countries can contribute to coping with these challenges.Objetivo: El estudio discute la necesidad del equilibrio entre las “antiguas y jóvenes” innovaciones para la construcción de sistemas de salud. Síntesis de los datos: Descripción de la trayectoria de los sistemas contemporáneos con análisis de las reformas hechas en Brasil, Chile, Colombia, España y Portugal. Se identificaron cinco momentos: la expansión de los servicios, las reformas “democrático-racionalizadoras”, los ajustes neoliberales, las reformas pro-coordinación, los nuevos ajustes y la propuesta de cobertura universal para los países de media y baja renta. En Chile y Colombia hubo la introducción explicita de los seguros privados y en Brasil la implementación de un sistema público integrado bajo financiación fiscal. En los tres países la segmentación y la fragmentación de los servicios aún predominan con una compleja composición de servicios públicos y privados. Portugal y España han implementado sistemas nacionales que integran “antiguas y jóvenes innovaciones” cuya macro eficiencia ha sido demostrada. Conclusión: En América Latina, las propuestas de universalización de la cobertura sin cambios en el modelo asistencial causan riesgos de un aumento desregulado del consumo sin correspondencia con las necesidades de salud de la población. El conocimiento y el debate a partir de las experiencias acumuladas en Brasil y en los países ibéricos pueden contribuir para el afrontamiento de eses desafíos.Objetivo: O trabalho discute a necessidade de se equilibrar “antigas e jovens” inovações na construção de sistemas de saúde. Síntese dos dados: Descrição da trajetória dos sistemas contemporâneos com análise das reformas feitas no Brasil, Chile, Colômbia, Espanha e Portugal. Cinco momentos foram identificados: expansão dos serviços, reformas “democrático-racionalizadoras”, ajustes neoliberais, reformas pró-coordenação, novos ajustes e proposta de cobertura universal para países de média e baixa renda. No Chile e na Colômbia houve a introdução explícita de seguros privados, no Brasil a implementação de um sistema público integrado sob financiamento fiscal. Nos três países a segmentação e a fragmentação dos serviços ainda predominam, com uma complexa composição de serviços públicos e privados. Portugal e Espanha implementaram sistemas nacionais que integram “antigas e jovens inovações”, cuja macroeficiência tem sido demonstrada. Conclusão: Na América Latina, propostas de universalização da cobertura sem mudanças no modelo assistencial trazem riscos de um aumento desregulado de consumo sem correspondência com as necessidades de saúde da população. O conhecimento e o debate a partir das experiências acumuladas no Brasil e nos países ibéricos podem contribuir para o enfrentamento desses desafios.Universidade de Fortaleza2018-12-21info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://ojs.unifor.br/RBPS/article/view/877910.5020/18061230.2018.8779Brazilian Journal in Health Promotion; Vol. 31 No. 4 (2018)Revista Brasileña en Promoción de la Salud; Vol. 31 Núm. 4 (2018)Revista Brasileira em Promoção da Saúde; v. 31 n. 4 (2018)1806-1230reponame:Revista Brasileira em Promoção da Saúdeinstname:Universidade de Fortaleza (Unifor)instacron:UFORporhttps://ojs.unifor.br/RBPS/article/view/8779/pdfCopyright (c) 2018 Revista Brasileira em Promoção da Saúdeinfo:eu-repo/semantics/openAccessConill, Eleonor Minho2022-02-16T12:40:49Zoai:ojs.ojs.unifor.br:article/8779Revistahttps://periodicos.unifor.br/RBPS/oai1806-12301806-1222opendoar:2022-02-16T12:40:49Revista Brasileira em Promoção da Saúde - Universidade de Fortaleza (Unifor)false |
dc.title.none.fl_str_mv |
Universal health systems for Latin America: recent and old innovations in health services Sistemas universales para América Latina: jóvenes y antiguas innovaciones de los servicios de salud Sistemas universais para a América Latina: jovens e antigas inovações nos serviços de saúde |
title |
Universal health systems for Latin America: recent and old innovations in health services |
spellingShingle |
Universal health systems for Latin America: recent and old innovations in health services Conill, Eleonor Minho Latin America Health Care Reform Innovation. América Latina Reforma dos Serviços de Saúde Inovação. |
title_short |
Universal health systems for Latin America: recent and old innovations in health services |
title_full |
Universal health systems for Latin America: recent and old innovations in health services |
title_fullStr |
Universal health systems for Latin America: recent and old innovations in health services |
title_full_unstemmed |
Universal health systems for Latin America: recent and old innovations in health services |
title_sort |
Universal health systems for Latin America: recent and old innovations in health services |
author |
Conill, Eleonor Minho |
author_facet |
Conill, Eleonor Minho |
author_role |
author |
dc.contributor.author.fl_str_mv |
Conill, Eleonor Minho |
dc.subject.por.fl_str_mv |
Latin America Health Care Reform Innovation. América Latina Reforma dos Serviços de Saúde Inovação. |
topic |
Latin America Health Care Reform Innovation. América Latina Reforma dos Serviços de Saúde Inovação. |
description |
Objective: The paper discusses the need to balance “old and recent” innovations in the construction of health systems. Data synthesis: Description of the trajectory of contemporary systems with analysis of the reforms conducted in Brazil, Chile, Colombia, Spain and Portugal. Five moments were identified: expansion of services, "democratic-rationalizing" reforms, neoliberal adjustments, pro-coordination reforms, further adjustments and the proposal of universal coverage for low- and middle-income countries. In Chile and Colombia there was the explicit introduction of private insurance and, in Brazil, the implementation of an integrated public system under fiscal financing. In these three countries, segmentation and fragmentation of services still predominate, with a complex composition of public and private services. Portugal and Spain have implemented national systems integrating "old and recent innovations", whose macro-efficiency has been demonstrated. Conclusion: In Latin America, proposals to universalize coverage without changes in the health care model pose risks of a deregulated increase in consumption, not corresponding to the health needs of the population. Knowledge and debate based on the experiences accumulated in Brazil and in the Iberian countries can contribute to coping with these challenges. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-12-21 |
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://ojs.unifor.br/RBPS/article/view/8779 10.5020/18061230.2018.8779 |
url |
https://ojs.unifor.br/RBPS/article/view/8779 |
identifier_str_mv |
10.5020/18061230.2018.8779 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://ojs.unifor.br/RBPS/article/view/8779/pdf |
dc.rights.driver.fl_str_mv |
Copyright (c) 2018 Revista Brasileira em Promoção da Saúde info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2018 Revista Brasileira em Promoção da Saúde |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de Fortaleza |
publisher.none.fl_str_mv |
Universidade de Fortaleza |
dc.source.none.fl_str_mv |
Brazilian Journal in Health Promotion; Vol. 31 No. 4 (2018) Revista Brasileña en Promoción de la Salud; Vol. 31 Núm. 4 (2018) Revista Brasileira em Promoção da Saúde; v. 31 n. 4 (2018) 1806-1230 reponame:Revista Brasileira em Promoção da Saúde instname:Universidade de Fortaleza (Unifor) instacron:UFOR |
instname_str |
Universidade de Fortaleza (Unifor) |
instacron_str |
UFOR |
institution |
UFOR |
reponame_str |
Revista Brasileira em Promoção da Saúde |
collection |
Revista Brasileira em Promoção da Saúde |
repository.name.fl_str_mv |
Revista Brasileira em Promoção da Saúde - Universidade de Fortaleza (Unifor) |
repository.mail.fl_str_mv |
|
_version_ |
1808844184894832640 |