title: [Capital accumulation patterns: capital and services in the current transformations of the health system].
abstract: The purpose of this article is to introduce elements of the capitalist society economic reproduction to the discussion around the current dynamics of health accumulation. It identifies the direction and significance of capital accumulation in the health area as well as the characteristics of the economic environment where the competition currently takes place. The hypothetic hypertrophy of the financial sphere is seen as a means for structuring the capitalist economy since the late twentieth century. The former delimitations between industrial production and service delivery are blurred and weakened; the competition process shows new features and the contradictions - internally between the different elements of the health industry and externally with other sectors - are changing. This article aggregates elements for a contemporary analysis of the "medical-industrial complex" on the basis of a theoretical-historical-conceptual approach. We identify changes in the capital dynamics of this complex at international and national level and stress the increasing role of the health services as a forefront of capital accumulation. The new approach is based on the economic thinking of Marx in addition to the current discussions about the theory of financial capital accumulation and the new productive configurations of the large corporations.
authors.affiliation: Instituto de Estudos de Saúde Coletiva, Departamento de Medicina Preventiva, UFRJ, Rio de Janeiro, RJ. siliansky@iesc.ufrj.br
authors.forename: Maria de Fátima Siliansky
authors.initials: Mde F
authors.lastname: de Andreazzi
authors.forename: George Edward Machado
authors.initials: GE
authors.lastname: Kornis
mesh_terms: D001938:Brazil; D030861:Capitalism; D003695:Delivery of Health Care / Q000191:economics*; D019981:Health Care Sector