A intersetorialidade da política pública de saúde : reflexões necessárias

Abstract

The capitalist economic system, through its world neoliberal hegemony, has widened Brazilian social inequalities on a daily basis, inducing precariousness in labor relations and social rights. Nowadays, proposals for reducing even more public investments are taking place, producing losses to the greater part of our population, by diminishing resources on Public Health Policies. In turn, intersectoriality, which is the subject considered in the present research, is presented as an interface proposal of the Unified Health System (Sistema Unico de Saude – SUS) at the amplification of its actions with other public social policies. However, there remain challenges of its implementation, although intersectoriality is present in Public Health Policy documents. This study shows, therefore, that the political, economic and social context does not favor the recommended fulfillment of intersectoriality of Public Health Policies, in order to reflect upon intersectoral action effectiveness. We also examine, from a historical viewpoint, the political, economic and social factors interfering in the constitution of Public Health Policies, and identify how intersectoriality is described in Public Health Policy documents. Along with this considerations, we understand the organic intellectual’s role as a potential mediator of the intersectoriality of Public Health Policies based on Gramsci’s work. As a theoretical basis, our reflections are conducted with dialectical materialism method, Marx and Engels’ writings and other Marxist authors’, making possible to understand how political, economic and social aspects in Brazil are articulated, and their impact on Public Health Policies. The methodological course of the present study is exploratory with qualitative data analysis with document and bibliographic research. We demonstrate, through the analysis conducted, that the historical evolution of health is intrinsically linked to Brazilian political, social, economic and cultural evolution, and it is inconsistent to dissociate the advance of capitalism that contributes to the non-fulfillment of intersectoriality of Public Health Policies. In this context, we dare to rethink forms and strategies to strengthen Public Health Policies and its Unified Health System through the intelligentsia of organic intellectuals, based on Gramsci (1982), in the use of intersectoriality as a constituent guideline of policies, and as an articulation possibility of other sectors and Public Health Policies.