Brazil’s policy on healthcare for government workers: players, paths and challenges

Ciencia e Saude Coletiva

Oliveira, Simone Santos¹  Andrade, Elsa Thomé de¹  Strauzz, Maria Cristina¹  Martins, Maria Inês Carsalade¹  Azambuja, Aline de¹  Castro, Larisse Caroline Ferreira de¹ 

[1]Fiocruz, Rio de Janeiro, Brasil

关键词: Health policy;    Workers’ health;    Healthcare;    Public administration;   

DOI  :  10.1590/1413-81232017225.33542016

学科分类：社会科学、人文和艺术（综合）

来源: Associacao Brasileira de Pos - Graduacao em Saude Coletiva

【 摘 要 】

This article aims to analyze the extent to which Brazil’s public sector has made progress in institutionalizing an integral and participative model for the healthcare of government workers, based on the principles of universality, integrality and workers’ participation. Based on documents produced by the Rio de Janeiro Permanent Forum on Workers’ Health, the paper analyses the process of implantation of the Integrated Public Workers’ Healthcare Sub-System (SIASS) in the municipality of Rio de Janeiro over the period 2009–2016, based on the historical institutionalism. Although it was conceived as an integrated system referenced to the principles of workers’ health, as from 2013 an inflexion was observed in this Subsystem, in the direction of a conservative model of occupational health, such as had been traditional and hegemonic in labor relations in Brazil. One factor that emerges is the loss of the universal character of the system due to the flexibility of employment relations in the public sector. There are various challenges: the need to expand the dialogue, and integration of the Policies on health, employment relations and management of the public administration, in such a way as to guarantee the principles of workers’ health and the universality of the system, evolving from the concept of the ‘public servant’ to that of the ‘public employee’.

【 授权许可】

CC BY