O sistema de saúde grego e a crise: um estudo de caso na luta pela capacidade do Estado Social

Charalampos Economou

doi:10.25761/anaisihmt.246

Charalampos Economou Professor, Panteion University, Department of Sociology

DOI: https://doi.org/10.25761/anaisihmt.246

Palavras-chave: Crise económica, programa de ajuste económico, reforma do sistema de saúde, sistema público de saúde, Grécia

Resumo

Este artigo analisa o impacto das políticas restritivas ditadas pela Troika no sistema de saúde grego. A maioria das medidas introduzidas durante a primeira fase das reformas (2010-2014) foram medidas de consolidação fiscal resultantes do aumento das barreiras ao acesso aos serviços de saúde e uma deterioração da saúde da população. Políticas que tendencialmente promoveriam as metas do sistema de saúde tais como cobertura universal, aquisição estratégica, avaliação da inovação tecnológica, medidas de saúde pública, mudança de internamento para cuidados em ambulatório, integração e coordenação de cuidados de saúde primários e secundários foram negligenciadas, enquanto que outras, por exemplo, a Organização Nacional para a Prestação dos Serviços de Saúde, a Rede Nacional de Cuidados Primários de Saúde e grupos de diagnóstico homogéneos (GDH) na versão grega, não foram bem planeadas nem implementadas devido aos exigentes objetivos reformistas e aos prazos impostos pelos memorandos. Embora depois de 2015 estes assuntos negligenciados tenham passado a constar como prioridades da agenda da política de saúde, outros continuam a necessitar de uma melhor abordagem em relação à abrangência do seguro social de saúde, a adequação do financiamento público da saúde, o desenvolvimento de um mecanismo de alocação de recursos, a reorganização do setor hospitalar, o desenvolvimento da medicina física e de reabilitação, os cuidados continuados e paliativos e o reforço dos serviços públicos de saúde. Usando o sistema de saúde como um estudo de caso, defendemos que “fortes” mecanismos de europeização caracterizados por austeridade fiscal e desvalorização interna resultam na retração do sistema público de saúde grego.

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