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The Brazilian Health Sector Reform and the Unified Health System: talking to competing hypotheses

Twenty years after the accomplishment of the Eighth National Health Conference and three decades after the foundation of The Brazilian Center for Health Studies, it is justified an analysis on the project, process and perspectives of Brazilian Health Sector Reform. Therefore, the aim of the present research is to analyze the emergence and the development of a Health Sector Reform inside a capitalist social formation, its foundations and characteristics, discussing the praxis challenges. The point of depart are four types of praxis and social changes: partial reform, general reform, revolutionary political movement and global social revolution. The thesis that is supported is that the Brazilian Health Sector Reform, as a social and historic phenomenon, is a social Reform. The hypothesis of the study is that the Brazilian Health Sector Reform, even though proposed as a global reform in its praxis and theorized to reach a revolution in people's way of life, has became a partial reform - sectorial and institutional. It was carried out a case study research based on documental analysis over two conjunctures. The descriptive component of the study was the cycle: idea-proposal-project-movement-process, and the explanatory one was the analysis of Brazilian society's development based on Gramsci's theoretical referential, particularly the categories of passive revolution and transformism. The results points in the direction of a partial reform. The importance of the Jacobin compound in a Democratic Health Sector Reform is discussed. In this case, the democratic radicalization would help change the correlation of forces, unbalancing the binomial conservation-change in the benefit of the latter and conferring a more progressive characteristic for the passive revolution.

Health Policy; Health Sector Reform; Brazil


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