Alternativas contratuais à prestação de serviço de saúde por municípios em consórcio público
This paper adresses contractual alternatives to the provision of health services by municipalities in a public consortium. The fundamental right to health, expressly provided for in the Constituição Federal de 1988 as a right for all and a duty of the State, requires the implementation of social and...
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| Formato: | postGraduateThesis |
| Idioma: | pt_BR |
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Universidade Federal do Rio Grande do Norte
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| Endereço do item: | https://repositorio.ufrn.br/handle/123456789/44207 |
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| Resumo: | This paper adresses contractual alternatives to the provision of health services by municipalities in a public consortium. The fundamental right to health, expressly provided for in the Constituição Federal de 1988 as a right for all and a duty of the State, requires the implementation of social and economic policies aimed at reducing the risk of disease and other health problems. The Sistema Único de Saúde emerges as a way of implementing the aforementioned constitutional command, organizing the health service in a decentralized, regionalized and hierarchical manner, in which executive competencies are concentrated on the entities that are closest to the population, that is, municipalities. However, the provision of health services is naturally costly and, therefore, it is inserted in a scarcity scenario, which is why it is necessary to make allocative choices aiming at its implementation. In the municipal scope, this scenario presents itself with greater vigor, since the vast majority of these entities have low collection capacity, which causes the poor implementation of the right to health in a perspective that is not only individual, but regionalized. In this context, municipal entities resort to pooling efforts in order to solve the problem presented, which occurs through the formation of a public consortium. However, the mere agglomeration of these entities in a public consortium does not have the power to resolve, by itself, the failures in the health service, requiring a perfect understanding of its limits and possibilities in order to enhance the associated management of public service. Aware of this problem, this work presents possible alternatives to be used within the scope of a public consortium with the objective of enabling the visualization of the best possible arrangement in view of the peculiarities inherent to its formation. To this end, it conducts an analysis of the fundamental right to health in the Federal Constitution of 1988, with a focus on the Unified Health System, municipal competences and the scarcity scenario. After that, analysis is brought about the Public Consortium, notably with regard to its legal regime, with special mention to the personnel regime, advantages of the institute and difficulties in its implementation. Thus, the way is opened for the presentation of contractual alternatives, starting the approach with Law 8.666/93, especially with regard to outsourcing, following with the analysis of the Regime Diferenciado de Contratações, also addressing the Parecias Público-Privadas regime and, in the end, interactions with the third sector. |
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