Privatization and Oligopolies of the Renal Replacement Therapy Sector on Contemporary Capitalism: A Systematic Review and the Brazilian Scenario.

Worldwide the assistance on renal replacement therapy (RRT) is carried out mainly by private for-profit services and in a market with increase in mergers and acquisitions. The aim of this study was to conduct an integrative systematic review on privatization and oligopolies in the RRT sector in the context of contemporary capitalism. The inclusion criteria were scientific articles without language restrictions and that addressed the themes of oligopoly or privatization of RRT market.

Proadi-SUS: analysis of financial resources in the three-year periods 2009-2011, 2012-2014 and 2015-2017.

Objective: To characterize the tax exemption resources used in the Support Program for Institutional Development of the Unified Health System (Proadi-SUS) in the 3-year periods 2009-2011, 2012-2014, 2015-2017, considering the total volume of resources linked to the debate on tax expenditures on health and the constitution of a "new form of philanthropy" in the sector.

Methods: To understand the philanthropic sector, tax expenditures between 2001 and 2017 were analyzed. To evaluate the resources used in the program, the values of projects and areas of activity were examined.

[A critical analysis of the implementation of the new model for allocating federal resources to primary healthcare: operationalism and improvisation].

This is a critical essay on policies for primary healthcare (PHC) adopted by the Jair Bolsonaro government in the Brazilian Unified National Health System (SUS), particularly in the first year of implementation of its new model for allocation of budget funds. The first part addresses the measures and effects of the first year, revealing the on-going process of valorization of an "operational SUS" as opposed to the principle of universality. The second part analyzes some evolving scenarios in the implementation of the new model for "financing" PHC in terms of losses and gains in funding, especially in two state capitals, São Paulo and Manaus, bearing a direct relationship to the problematic situation a year since the novel coronavirus pandemic struck.

[International capital companies and the Brazilian health system: a study on renal replacement therapy].

Since the liberalization of foreign capital in health a new trend has arisen in the process of capital accumulation in the industrial economic complex of health, especially at the levels of outsourced care and Services of Care, Treatment and Diagnosis (SCTD). In order to contribute to the understanding of this dynamic, this article sought to analyze the acquisition process of Renal Replacement Therapy (RRT) clinics by international capital companies in Brazil. To achieve this, a two-stage methodological path was developed; the first consisted in the quantitative-descriptive analysis of the economic type of all the international capital companies that operate in the production of input and technologies and in RRT care services; the second was developed by a qualitative analysis of semi-structured interviews of key actors from the private and public sectors and organized civil society.

Coronavirus, Capitalism in Crisis and the Perversity of Public Health in Bolsonaro's Brazil.

This article aims to discuss the meaning of the coronavirus crisis as an integral part of the totality of the capitalist crisis and its implication in the health area of Brazilian capitalism, in which the rise of ultraliberal and neofascist policies is witnessed by the Bolsonaro government. To this end, we opted for a historical-dialectical materialist analysis of the situation experienced between the global beginning of the pandemic until the month of May 2020 in Brazil. The article is structured in 2 parts: The first discusses the problem of agrifood systems in the context of capitalism in crisis and its effects on the spread of diseases such as the coronavirus, and the second discusses the neglect of the Bolsonaro government in facing the COVID-19 pandemic and the Brazilian universal health system.

A methodology for apportioning federal SUS resources: the health needs index.

OBJECTIVE To present a methodology for apportioning Union resources to the federative units (FU - 26 states and one federal district) within the Brazilian Unified Health System (SUS) based on health needs measured by demographic, socioeconomic, epidemiological and geographical dimensions. METHODS The apportionment methodology proposal prioritizes the health needs axis, based on Law 141/2012. We adopted a proxy of needs that measures relative inequalities between, socioeconomic, geographic demographic and epidemiological conditions of the populations of the Brazilian Federative Units (FU) for 2015.

Nursing workers: achievement of formalization, hard work and collective action dilemas.

The singularity of the collective action of nursing categories in sociopolitical participation is the subject of our analysis. This paper attaches the compelling factors of social origin and aspects of the labor market to the political action of professionals. Based on the analytical association of the extended case method, we articulated the interpretation of the database of the Brazilian Nursing Profile Survey, specifically, in the light of socioeconomic identification, labor market, and working conditions, with an ethnographic study and semi-structured interviews in three hospital units.

Assessment of health technical efficiency in the cities of the Rota dos Bandeirantes health region of the state of São Paulo, Brazil.

Although administrators unanimously agree that the Brazilian Unified Health System (SUS) is underfunded, it is also unanimous that there are problems in the efficiency of expenditures management. From this perspective, this study assessed the health technical efficiency in the seven cities of the Rota dos Bandeirantes health region of the state of São Paulo, Brazil, from 2009 to 2012, through the Health Technical Efficiency Index. This index includes structure and results indicators, mainly from the goals and indicators agreement system, and it is collected from the database of the SUS Informatics Department.

International Trade and Health Care in Brazil: An Unpredicted Tale Threatening Health Care Entitlement?

The General Agreement on Trade in Services (GATS), established in 1994, has been a key element of market liberalization of health care services. Brazil had the provision of health care services partially protected from international competition until 2015, when a constitutional change opened the national health care market to international provision. We performed a retrospective and prospective policy analysis based on a systematic policy document review, general literature review, and secondary data analysis mapping, describing and analyzing the international trade agreements signed by Brazil with the World Trade Organization (WTO) and the available legislation relevant to health care services.

Commodification in the reforms of the German, French and British health systems.

Since the 1980s, European health systems have undergone several reforms, with emphasis on the tendency of their commodification. The objective of this article is to demonstrate how market mechanisms were implemented in the functioning of these systems, german, british and french - from the 1980s. The "mercantile" reforms were justified on the premise that the insertion of market logic could both reduce the need for public spending and increase the efficiency of existing expenditure.

The Brazilian Public Health in Contemporary Capitalism.

This article examines some political and economic facts that led to an intensification of austerity measures by the Brazilian government, including ones against the Unified Health System (SUS) and its progressive dismantling. In a country where fundamental human rights were never fully respected, nowadays social and labor rights are under severe attacks. The deepening of the capital crisis and the rise of interest-bearing capital dominance have been causing unemployment, social insecurity growth, and resulting public fund appropriation by the private capital.

Analysis of the Unified Health System funding and expenditure in the municipalities of the "Rota dos Bandeirantes" health region, State of São Paulo, Brazil.

The national scenario of lack of resources in the Brazilian Unified Health System (SUS) has led to major differences in the municipalities funding models. Thus, this study aims to analyze SUS funding and expenditure in seven cities of the Rota dos Bandeirantes health region, State of São Paulo, SP, Brazil, from 2009 to 2012. Settled expenditure indicators were collected from the Public Health Budgets Information System (SIOPS) for analysis, showing descriptive data with absolute and relative frequency calculations.

Outsourcing and "dismantling" of steady jobs at hospitals.

Objective: To relate hospitals' organizational structure as the core of a web of outsourced services and flexible employment bonds among healthcare professionals in the context of finance capitalism, analyzing work arrangements based mainly on the type of employment bond.

Method: Qualitative research through ethnography, interviews, data analysis, and case studies. The case studies were concentrated in 3 hospitals located in the São Paulo metropolitan region under different management types: public administration; outsourced administration via a healthcare social organization (HSO); and private administration.

[Costs of the chain of treatment procedures in acute myocardial infarction in Brazilian reference and specialized hospitals].

Objective: To present the methodology and the results of a field survey to assess the chain costs of procedures for treatment of acute myocardial infarction (AMI), carried out in 11 Brazilian reference and specialized hospitals.

Methods: The cost assessment used the cost per procedure and per pathology systems. The procedures associated with the treatment of AMI were organized and their logical sequence (protocols) was used to create a flowchart.

The financing of SUS in a scenario of financialization.

This article rebuilds the process of the institutionalization process of the financing of Unified Health System (SUS), impaired, initially, by the macroeconomic policy conditions, developed during the decades of 1990 and 2000, and, ultimately, by the effects caused by the present phase of capitalism, concerning financial capital supremacy. It also identifies, within the political and economic framework, conflicts existing with the economic area of the federal government, highlighting the conditions imposed to financing and the concept of health, being universal and an essential component of Social Security.

[Brazilian Ministry of Health policy providing incentives for basic health care: a threat to the autonomy of Municipal administrators and the principle of integrality?].

Thirteen years after the Unified National Health System was implemented in Brazil, the Federal government increased the use of norms and regulations aimed at rationalizing resources and prioritizing basic care within the system. In other words, although actions and services are the responsibility of Municipal governments, the Federal government used financing to reinforce its role in determining the policy to be adopted. The first part of this article analyzes trends in health care expenditures and financing in the country and priorities and strategies for financing.