Descentralização e federalismo: a política de saúde em novo contexto - lições do caso brasileiro

[摘要] The article analyses the processes of decentralization and deconcentration, along with the new emergence of federalism, as global phenomena and meaningful tendencies in the reestructuring of the unitary and centralized State, built under the Napoleonic tradition. In the Brazilian case, in particular, the article identifies the different phases and problems that arose during the decentralization process and within the re-configuration of the federative pact since the 80's, and evaluates the implications of this new order on the recent reform processes of the health policy. Furthermore, the article presents the conditions and limitations of healthsystem's decentralization, highlighting the risks to which it is submitted and taking into account unfavourable aspects of its context, characterised by federative conflicts and by the social and economic inequality inheritance.

[关键词] Health politics' decentralization;Intergovernmental relations;Federalism;Health system;SUS's Basic Operational Norms;Descentralização da política de saúde;Relações intergovernamentais;Federalismo;Sistema de saúde;Normas Operacionais Básicas do SUS