[The federal government discourse during the political decentralization process and the obstacles to implement the Brazilian Public Health Care System].
A discourse analysis carried out on basic operating standard Norma Operacional Básica do Sistema Unico de Saúde (NOB-SUS 01/96) of the Brazilian public health care system aiming at locating signs that could allow to identify lines of thought which have influenced health care policies prioritized by the federal administration. The author points out a peculiarity in the kind of discourse employed by the ministry directive: its structure is based on isolated aspects of legislation and on ideas advocated by other discourse communities, articulated with redefined legal principles - an effort towards authorizing the official reasoning in favor of the relevance in keeping the decentralization process under the control of the federal administration. The analysis concludes that an infra-legal standard can neither grant state and federal administrations a hierarchical superiority (mediation function) over municipal administrations, nor can it transfer the legal responsibilities pertaining to Health Councils over to inter-administration commissions (Comissões Intergestores) , thus making the former mere decision ratifiers. This study found that granting privileges not contemplated in the legislation to state and federal administrations surfaced again and more strongly so in 2001 in yet another operating standard.
Escola de Comunicação, Universidade Federal do Rio de Janeiro, Vital Brazil, 24.220-200 Niterói RJ. pellegrini@terra.com.br
Bárbara
B
Pellegrini
D001938:Brazil; D003695:Delivery of Health Care / Q000458:organization & administration*; D035082:Federal Government; D018166:Health Care Reform; D011057:Politics; D011634:Public Health