The regionalization of health in Brazilian federalism

Abstract

The approach to regionalization, constitutional guideline organizer of the Unified Health System (SUS), was based on the foundations laid in the constitutional framework and its concepts in order to verify the effectiveness of regionalization in the Brazilian federal system. Was approached, too, the concept of decentralization, a process that allowed the transfer of decision-making power of federal government to states and municipalities. From the literature review and federal law, we analyzed the implications of intergovernmental relations established for effective regionalization of health services and actions. The institutional structure of SUS shows that coordination of regionalization is driven model of federalism, with powers and tasks defined by the Constitution and the Organic Law of Health, for the three counties.  It was concluded that regionalization is the SUS cooperative federalism expressed in intergovernmental relations, based normative well defined, however, there are still some critical factors such as the heterogeneity of the Brazilian federal structure, the political culture of the country, the responsibilities of the municipal executive, management and cooperation among entities within the region.