EL SISTEMA DE SALUD DE LOS ESTADOS UNIDOS: MITOS Y REALIDADES (PARTE I)

Autores

  • Celia Iriart University of New Mexico

DOI:

https://doi.org/10.18310/2446-4813.2016v2n1p07-21

Palavras-chave:

Estados Unidos, Sistema de salud, Reforma, Derechos, Desigualdades

Resumo

ResumenObjetivos: Analizar el sistema de salud de los Estados Unidos (EUA) considerando la compleja red que oculta el concepto de sistema basado en la ideología del libre mercado, el financiamiento administrado sustancialmente por compañías de seguro y administradoras de medicamentos, y la provisión por proveedores privados (lucrativos y no lucrativos) y estatales altamente comercializados. La importancia de desarrollar este análisis radica en lo poco que se conoce en otros países cómo funciona este sistema y en la admiración que produce en el imaginario colectivo, en especial, cuando grupos de interés lo muestran como la solución para supuestos déficits fiscales del sector salud y la ampliación de la oferta de alta complejidad y medicamentos de última generación en países con sistemas basados en acceso universal y provisión pública (total o parcial).Métodos: Analítico-interpretativos de datos secundarios.Fuente de datos: Mayoritariamente fuentes gubernamentales o documentos basados en ellas. Resultados: Los datos analizados contextualizan a nivel socio-demográfico, laboral y económico la reforma del sistema de salud aprobada en el 2010, analiza las desigualdades en acceso a seguro médico, así como las dificultades de obtener servicios debido a los altos costos que deben pagar asegurados y no asegurados.Conclusiones: Es imperioso extraer lecciones de la reforma de los EUA que obliga a que individuos y empleadores deban comprar seguros a empresas privadas que dan cobertura según la capacidad de pago de los contratantes. La ausencia del derecho a la salud deja a los usuarios librados a reclamar derechos en tanto consumidores, no  como ciudadanos de pleno derecho.ResumoObjetivos: Analisar o sistema de saúde dos Estados Unidos da América (EUA) considerando a complexa rede que oculta o conceito de um sistema baseado na ideologia do livre mercado, no financiamento administrado substancialmente por companhias de seguro e administradoras de medicamentos, e na provisão de serviços pelos privados (lucrativos e não lucrativos) e estatais altamente comercializados. A importância no desenvolvimento desta análise é radicada no pouco conhecimento que se tem, nos outros países, de como funciona este sistema e na admiração que é produzida, no imaginário coletivo, em especial em quanto grupos economicamente interessados o presentam como uma solução, em países com sistemas baseados no acesso universal e oferta pública de serviços (total ou parcial),  do suposto “déficit fiscal” do setor saúde, e a possibilidade de ampliação de acesso às tecnologias de alta complexidade e aos medicamentos de última geração.Métodos: Analítico-interpretativos de dados secundários.Fonte de dados: Majoritariamente fontes governamentais ou documentos produzidos pelas instâncias governamentaisResultados: Os dados analisados contextualizam o nível socio-demográfico, do trabalho e econômico a reforma do sistema de saúde, aprovada em 2010, analisa as desigualdades de acesso aos seguros médicos, assim como as dificuldades na obtenção dos serviços de saúde pelo alto custo que os segurados e não segurados devem pagar.Conclusões: É fundamental tirar lições da reforma dos EUA, que obriga os indivíduos e os empregadores comprarem seguros de saúde de empresas privadas, que dão cobertura de acordo com a capacidade de  compra dos contratantes. A ausência do direito à saúde coloca os usuários como meros consumidores e como tal reclamarem direitos enquanto tais e não como cidadãos plenos de direitos sociais.AbstractObjectives: Analyze the US health care system considering the complex network that is hidden under the concept of a system based on the ideology of free market, on the financial management by insurance companies and by those that manage medical drug benefits, and on the provision of services by private (for-profit and not-for-profit) and highly commercialized governmental services. The importance of developing this analysis resides on the lack of knowledge in other countries in regards to how the system works and the fascination created in the collective vision by interest groups. These groups show this type of system as a solution to reduce supposed fiscal deficits and expand access to high technology and the most advanced medical drugs in countries with systems based on universal access and public provision of services (total or partial).Methods: Analytical-interpretative, based on secondary data.Data sources: Mostly governmental sources and documents based on them.       Results: The analyzed data contextualizes the health care system reform approved in 2010, at socio-demographic, labor and economic levels, and it analyzes the inequities in medical insurance access, as well as the difficulties in obtaining health care services as a consequence of the high costs that must be paid by insurer, underinsured and uninsured populations.Conclusions: It is imperative to extract lessons of the US health care reform, which requires that individuals and employers purchase insurance from private companies that provide coverage based on payment capacity. The absence of health rights leaves the users of health care services with only the option of demanding consumer rights, not citizenship (in ample sense) rights. 

Biografia do Autor

Celia Iriart, University of New Mexico

Family and Community Medicine - Public Health Program

Referências

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Publicado

2016-05-25

Como Citar

Iriart, C. (2016). EL SISTEMA DE SALUD DE LOS ESTADOS UNIDOS: MITOS Y REALIDADES (PARTE I). aúde m edes, 2(1), 07–21. https://doi.org/10.18310/2446-4813.2016v2n1p07-21

Edição

Seção

Sistemas de Saúde