Organizações sociais de saúde como forma de privatização do Sistema Único de Saúde
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Data
2020-10-30
Autores
Turino, Fabiana
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Universidade Federal do Espírito Santo
Resumo
This PhD thesis focused on the theme of privatization of the Unified Health System (SUS) through the entry of Social Health Organizations (OSS) in the management of these services. The methodology used was a mixed, qualitative and quantitative approach. The main objective was to investigate how the transfer of public resources to private non-profit entities creates new characteristics for the Brazilian public health system. To achieve this goal, management contracts and additive terms of the agreements signed between the OSS and the health departments of the states of Rio de Janeiro and São Paulo, as well as with their capitals, between 1998 and 2018 were analyzed. The results of this investigation are arranged in the thesis in four articles. The first was a theoretical analysis and a systematic review that pointed to New Public Management as a central argument for administrative reforms that resulted in actions to reduce bureaucracy and make public management more flexible. In the second article, the use of the management contract as a legal instrument to enable the SUS privatization process was analyzed. The third article, on the other hand, confirmed that the use of additive terms from management contracts results in the instrumentalization of the privatization process. Finally, the fourth article presented the double certification of non-profit organizations as a problem, as they add entitlements - OSS and philanthropy - that enable tax advantages. This evidence supports the conclusion that the transfer of the management of public health services to OSS is a process of functional and fluctuating privatization
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Organização Social , Privatização , Saúde Pública , Gestão Pública , Financiamento Público , Sistema Único de Saúde (SUS) , Social Organization , Privatization , Public Health , Public Management , Public Funding