O Sistema Único de Saúde ante as perspectivas da terceirização administrativa

Abstract

The guarantee of the right to health with constitutional status increased the demand for public services in the area of health, affecting the adoption of forms of private management and administrative reform of the State leading to the proliferation of administrative laws aimed at the possibility of the public power to enter into partnerships with the private sector for the purpose of providing public health services by the Unified Health System. The relationship between the rules of public law and the inspiration based on private rules gave rise to the peculiarity of the public-private mix present in the Brazilian health system, which between state power and the private sector. Based on the current notion of subsidiarity in article 173 of the Constitution of the Republic, the research aims at addressing issues related to the obstacles faced by the State, from the perspective of the (im) factual possibility of Public Administration to carry out "administrative partnerships" the civil society to highlight the challenge of the compatibility between the density of the state apparatus and the difficulty of establishing efficient and well-planned forms of State action in the realization of rights. It is in this area that this study draws from the use of historiographical and documentary analysis, law in the broad sense, books, scientific articles, scientific journals, reviews, management and governance reports, jurisprudential studies of judicial decisions, as well as virtual libraries and data, on the socioeconomic and historical moment that influenced the creation of the Unified Health System, setting up a real puzzle of the positive and negative aspects of the delegation / outsourcing of the provision of public health services. The result of the study shows two incontestable situations: the outsourcing of health services developed by the private sector can only occur in complementary activities, as decided by the Federal Supreme Court; the point of criticality of this administrative framework arises from the failure of management of governance in tracing goals (efficiency) and results (effectiveness).