Political Economy of Health and the Financing of Contemporary Universal Health Systems in the Light of Paul Singer’s Thought

Abstract

Universal health systems are susceptible to the structural crises of capitalism and have had to adapt to the sudden social changes in the neoliberal scenario, with commodification, drastic cuts in resources and changes in financing schemes. The discussion on the sustainability of systems has required that the economic instrument be increasingly considered, which requires the use of the theoretical framework of political economy and a critique of the predominant neoclassical narrative. The study aims to identify, through a systematic review of the literature, the production on the theme of financing systems in the context of the political economy of health in the light of the contribution of the Austro-Brazilian economist Paul Singer, in the work “Prevenir e Curar: o Controle Social Através dos Serviços de Saúde” ( Singer et al., 1978 ). Of the 47 articles included in the Review, only 33.6% promote discussions focused on political economy; of these, 76.6% are aligned with Keynesian thought and 23.4% with the Marxist view. There is convergence in relation to the dimensions discussed by Singer: historical perspective (91.5%), health systems under the aegis of the capitalist State (100%), social control (23.4%), health status (57.4%) and evaluation criteria (72.3%). The identified studies and Singer’s thinking converge in identifying the limitation of Economics in the face of the insertion of the health issue within the scope of the interests that make up capitalist society.