Brazilian health federalism: perspective of regionalization in the brazilian Nacional Health System

Abstract

This study looked for the legal and institutional bases present in constitutional order and in health legislation that provide for regionalization of health actions and services in Brazilian federalism. The analysis was based on the recognition that, due to the federal nature of the Brazilian National Health System (SUS), regionalization is conditioned by the model of federalism existent in Brazil and by its expression in health. The fundamentals of federalism as a form of state organization were reviewed and then particular elements of cooperative federalism in Brazil were exposed, exploring two main modalities of intergovernmental relationship in federal context, “regional urban planning” and “public consortium”. The structure of Brazilian health federalism was presented and its construction process was examined through an approach on the political and administrative decentralization in the municipal and regional dimensions, observing especially the current guidelines prescribed by the Health Pact. It was concluded that regionalization in the SUS has a normative basis well established and represents a legitimate manifestation of cooperative federalism supported by the Brazilian health law.