Estado e políticas públicas : a participação da categoria médica na formulação e implementação das políticas para a saúde no Brasil

Abstract

The present work has the central objective of analyzing the historical process of constitution and formation of the medical category in Brazil, thus identifying how this category could be the main reference in terms of mediation in the development of the formulation and implementation activities of the adopted public health policies by the Brazilian State. Therefore, through a documental analysis, the formation of the health sector and the formation of the medical category as a political agent capable of mediating relations in the sector were analyzed. For this analysis, the cognitive and normative approaches were used grounded on Jobert and Muller's (1987) Frame of Reference, Gramsci's (2011) concept of State and Hegemony, the perspective of Decoloniality based on the colonial matrix of power by Quijano (2009) and Mignolo's (2012) border thinking. Data has shown that the historical characteristics of the formation of the Brazilian State and its subordination to global hegemonic references determined the formation of the health sector and the professional categories of this sector. It was also noticed that the impositions of public policies were directed towards the transformation of the sector in order to meet the dominant needs and expectations, that at first the medical category was responsible for full mediation, but with its institutionalization, space for other mediators agents emerged, in which the Ministry of Health was more qualified in this matter.