Article
Do Elections Matter for Private Sector Healthcare Management in Brazil.pdf
BMC Health Services Research
(2017)
Abstract
Background: This study analyzed several political determinants of increased private-sector management in Brazilian
health care. In Brazil, the poor depend almost exclusively on the public Unified Health System (the SUS), which
remains severely underfunded. Given the overhead costs associated with privately contracted health services,
increased private management is one driver of higher expenditures in the system. Although left parties campaign
most vocally in support of greater public control of the SUS, the extent to which their stated positions translate
into health care policy remains untested.
Methods: Drawing on multiple publicly available data sources, we used linear regression to analyze how political partyin-
power and existing private sector health care contracting affect the share of privately managed health care services
and outsourcing in municipalities. Data from two election periods—2004 to 2008 and 2008 to 2012—were analyzed.
Results: Our findings showed that although private sector contracting varies greatly across municipalities, this variation
is not systematically associated with political party in power. This suggests that electoral politics plays a relatively minor
role in municipal-level health care administration. Existing levels of private sector management appear to have a greater
effect on the public-private makeup of the Brazilian healthcare system, suggesting a strong role of path dependence in
the evolution of Brazilian health care delivery.
Conclusion: Despite campaign rhetoric asserting distinct positions on privatization in the SUS, factors other than political
party in power have a greater effect on private-sector health system management at the municipal-level in Brazil. Given
the limited effect of elections on this issue, strengthening participatory bodies such as municipal health councils may
better enfranchise citizens in the fundamental debate over public and private roles in the health care sector.
Keywords
- Health systems,
- Brazil,
- Unified health system,
- Sus,
- Private contracting,
- Neoliberalism,
- Political parties
Disciplines
Publication Date
Summer July 12, 2017
DOI
10.1186/s12913-017-2427-5
Citation Information
Alecia McGregor, Carlos Eduardo Siqueira, Alan M. Zaslavsky and Robert J. Blendon. "Do Elections Matter for Private Sector Healthcare Management in Brazil.pdf" BMC Health Services Research Vol. 17 (2017) p. 483 Available at: http://works.bepress.com/carlos_siqueira/35/
Creative Commons license
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