A reforma da administração pública sob a abordagem gerencial na concretização do direito fundamental a saúde pós constituição de 1988.

Abstract

This thesis focuses on “The public administration reform under a managerial approach in the implementation of the fundamental right to health after the Constitution of 1988”, which highlights the need for a public administration reform. It analyzes the characteristics of the three public management strategies of the Brazilian state apparatus throughout its history: the patrimonial, the bureaucratic and the managerial approach. It also presents alternatives to overcome this patrimonialism and to improve the bureaucratic system, while incorporating managerial methods to adapt and execute public policies geared towards developing and realizing fundamental human rights. Ultimately, with the goal to reduce the unbalance of social demands and the capacity of the state to meet the needs, specially the public health policies of the state. After the Federal Constitution, in 1988, it became a state duty to guarantee the right to health to everyone. As such, considering all the aspects regarding the managerial reform of the administrative structure of the state, it is possible to explore the possibilities of decentralization through the participation of private initiative and third sector in public health actions and services, which have more autonomy and flexibility in their activities towards the public benefit. As per the topic of this study, and in contrast to the good policies of public administration, there is an increase of the number of lawsuits regarding the fundamental right to health. In view of that, it is imperative to improve public administration to better address the public needs and to dispel the misperception that civil services are inherently inefficient. Finally, by carrying out biographical research about the topic and applying hermeneutic methods, it was concluded that the managerial method, when applied to public administration, allows for better streamlining of public resources, given its primary aim for accountability. Not only does it enhance public service delivery, but it also brings citizens closer to public activities, as well as provides the constitutional right to public health.