A focalização utilitária da Atenção Primária à Saúde em viés tecnocrático e disruptivo

Abstract

An essay about the contextual meaning, the conjunctural conditioning and the strategic indicatives within the “Previne Brazil Programme”, which establishes a new logistics and funding modality for Primary Care in the Brazilian Unified Health System. It contextually highlights the neoliberal hegemony, with a tendency towards a subservient colonization of governments and public policies and in conjuncture, the disruptive alignment of the Bolsonaro government, permeated by ultraliberal offensives, imposing biases and authoritarian practices. In concomitant derivation, this programmatic strategy tends to substantiate a new form of targeting for stratified demands and segmentation for hedges and health services. Being governed by a technocratic and utilitarian rationality, which tends to disregard the precepts and constitutional strategic guidelines of public health policies. It is characterized mainly by: capitation and per capitalization of “manageable” demands, in terms of “clinical governance” regulated by austerity economic policy and social spending contingency; displacement of the territorial and population mode of enrollment with the accountability of multiprofessional teams aiming at Integral Health Care, to another individualized, focused and stratified mode of clientele; decontextualized applicability of the health system, with criteria and logistics of allocative weighting of financial resources of cost and compensatory payment to the “performance” of team work