The increase of philanthropic entities in the SUS: what does this scenario reveal? / O aumento de entidades filantrópicas no SUS: o que esse cenário revela?

ABSTRACT The article analyzes aspects of the change in the legal nature of private healthcare from "for-profit" to "non-profit" entities. It is an exploratory research, supported by the policy analysis framework, focusing on secondary data from the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities - CNES) from 2012 to 2020 and a case study. The results show an increase in these entities in all regions of the country and evidence that they behave like profit-oriented entities. The change in legal nature hides a broader process of implicit commodification of healthcare services, encouraged by state policies and related to exemptions provided by law.

RESUMO O artigo analisa aspectos da mudança da natureza jurídica de instituições privadas de assistência à saúde, de estabelecimentos "com" para "sem" fins lucrativos. Trata-se de uma pesquisa exploratória, apoiada no referencial de análise de políticas, com foco em dados secundários, provenientes do Sistema de Cadastro Nacional de Estabelecimentos de Saúde (SCNES), de 2012 a 2020, e estudo de caso. Os resultados apresentam aumento dessas entidades em todas as regiões do país e evidências de que se comportam como estabelecimentos com fins lucrativos. A mudança de natureza jurídica oculta um processo mais amplo de mercantilização implícita dos serviços de saúde, incentivado por políticas estatais e relacionado às isenções previstas em lei.

COTOGA: participación, lucha y colectivo / COTOGA: participation, struggle and collective

Desde la creación de la Asociación Profesional Gallega de Terapeutas Ocupacionales (APGTO) en 1983, siendo la primera a nivel estatal, se luchó activamente en nuestra comunidad para tener una red organizativa fuerte y sólida que representase y defendiese los intereses de la terapia ocupacional. El camino realizado por la APGTO desembocó el 30 de octubre de 2017 al crearse el que es hoy, el Colegio Oficial de Terapeutas Ocupacionales de Galicia, una entidad pública con representación jurídica propia, organizada de manera altruista por una junta directiva liderada por terapeutas ocupacionales y creada con el fin de defender los derechos y deberes de las personas colegiadas y de la población susceptible de su intervención y, además de contribuir a la difusión y promoción de la actividad profesional de terapia ocupacional en sus diferentes ámbitos. (AU)

Since the creation of the Galician Professional Association of Occupational Therapists (APGTO) in 1983, being the first at the state level, there has been an active struggle in our community to have a strong and solid organizational network that represents and defends the interests of occupational therapy. The path followed by the APGTO ended on October 30, 2017 with the creation of what it is today, the Official College of Occupational Therapists of Galicia, a public entity with its own legal representation, altruistically organized by a board of directors led by occupational therapists and created in order to defend the rights and duties of the collegiate people and the population susceptible to their intervention and, in addition to contributing to the dissemination and promotion of the professional activity of occupational therapy in its different fields. (AU)

“Ser, hacer y llegar a ser” del consejo general de colegios de terapeutas ocupacionales (CGCTO) / Being, doing and becoming of the general council of occupational therapist colleges (GCOTC)

La nueva Junta del Consejo General de Colegios de Terapeutas Ocupacionales acabamos de embarcarnos en este nuevo desafío de seguir navegando por y para la Terapia Ocupacional. Siento que no vamos solas y que nuestro mayor deseo es que este viaje lo hagamos junto con el resto de compañeros/as terapeutas ocupacionales. Para mí, es la mejor manera de que entre todos/as podamos contribuir al crecimiento de nuestra profesión, cada uno desde su lugar, en esta realidad presente y de la mejor manera que sea posible. (AU)

The new General Council Of Occupational Therapist Colleges Board has just embarked on this new challenge of continuing to navigate through and for Occupational Therapy. I feel that we are not going alone and that our greatest wish is that we do this together with the rest of our partners occupational therapists. For me, it is the best way for all of us to contribute to the growth of our profession, each one from their place, in this present reality and in the best possible way. (AU)

Politicizing women's choices--again.

Why the commotion over Planned Parenthood and Ann Romney matters.

Partnership working in services for children: use of the common assessment framework.

Transformation in the structure and delivery of services for children and young people in the UK Children Act (Department for Education & Skills, 2004. The Children Act. London: HMSO) initiated new alliances between statutory, public and voluntary agencies. Traditional relationships and notions of partnership have been extended, necessitating an innovative approach to dialogue and multiple perspectives. Hudson's assertion that although the "rhetoric on partnering remains strong, the real policy thrust is now about choice and contestability" (2006, Journal of Integrated Care, 14(1), 13-21) exemplifies the dynamic policy context around notions of partnership and the rationale for collaborative advantage. This paper explores the experiences of practitioners working in a relatively new multi-agency context--the common assessment framework (CAF). Envisaged as a standardized approach to the assessment of need and as a tool to facilitate integrated working, the CAF is utilized by practitioners in the UK to improve outcomes for children and young people. We present data from a study that employed an interpretative phenomenological analysis approach and gathered semi-structured interviews with 20 practitioners. Interviews drew upon their experiences of interprofessional working in which diversity, partnership working, and competing aims and objectives emerged as significant themes. The insights that were gained are discussed in terms of their potential impact on service delivery in the UK and their contribution toward responsive practice across dynamic professional boundaries.

A conflict of responsibility: no patient left behind.

In its program END THE WAIT, the National Kidney Foundation (NKF) outlined four comprehensive strategies to achieve the goal that within 10 years, every individual on the US waiting list will receive a transplant within 1 year of listing. Lifetime immunosuppressive coverage is a critical piece of the foundation of this program. Events in 2009 that were dedicated toward achieving a lifetime immunosuppressive benefit were complicated by legislative challenges and a dynamic that placed oral medications in the ESRD bundling proposal in direct conflict with the potential for the lifetime immunosuppressive benefit. In line with its mission, the NKF could not sacrifice one kidney patient constituency for another. Successful patient-centered organizations stay consistent with their mission. The NKF had to weigh the risk of postponing a long-sought goal and its relationships with other organizations with standards of patient safety and equitable and efficient patient care. In a perfect world, we never have to make such choices. In the real world, we can use such choices to forge new ways and dialogue to achieve better health care for all patients affected by kidney disease.

Voluntary patient assistance programs: additional federal oversight unwarranted.

The Partnership for Prescription Assistance, which links struggling patients to more than 475 patient assistance programs, provides a vital safety net for millions of uninsured Americans. Proposing unwarranted government regulation during these uncertain economic times could cast a chill nationwide on other philanthropic efforts.

Reforming patient assistance programs: perfect world meets real world.

Drug company-sponsored pharmacy assistance programs (PAPs) are an imperfect solution to a wide-ranging access problem. These programs help millions of people with chronic conditions get life-saving medications. Spending funds to tinker with these programs would distract from the systemic problems facing the health care system and risk placing a higher bureaucratic burden on providers and patients. The net effect would be reduced access to prescription drugs for many who rely on PAPs for their medications. Solutions should be sought to tackle fundamental problems facing an overburdened health care system. These solutions must involve a reexamination of priorities, not of functioning programs.

Philanthropies croisées: a joint venture in public health at Lyon (1917-1940).

Since the end of the First World War the Rockefeller Foundation has spearheaded a large-scale programme in the field of education for the health professions (doctors and nurses). In several countries throughout the world, but with its efforts concentrated on Europe, it has financed schools, constructed information networks, granted research scholarships and awarded training bursaries. In so doing it has not, however, been in the business of propagating an irresistible "American model," nor has it pursued a huge undertaking in disinterested aid. Through an attempt to contextualize these programmes, to bring to light the existence of common reference points, to retrace the work with local participants and to appraise cleavages within the philanthropic apparatus, this article proposes a fine-grained reading of the role of the Rockefeller Foundation at the Faculté de Médecine (Faculty of Medicine) and the Ecole d'Infirmières et d'assistantes sociales (Training School for Nurses and Social Workers) in Lyon between 1917- and 1940. It analyses these institutions in terms of the transactions, negotiations and appropriations that highlight their joint-venture character and it identifies their varied impact.

Critical role of the March of Dimes in the expansion of newborn screening.

Expansion of newborn screening (NBS) has been driven primarily by a combination of advances in technology and medical treatment, and the sustained advocacy efforts of consumers and voluntary health organizations. The longstanding leadership of the March of Dimes has been credited by many as a critical factor in the expansion and improvement of state NBS programs. From the historic vantage point of four decades of March of Dimes involvement with newborn screening, this report reviews the unique origin of the first newborn screening test, and identifies from this point of origin several of the elements which still define the evolution of advocacy for NBS today. It also documents activities at the federal level and in seven states that have lead to expanded screening for newborns. Advances in NBS technology and medical treatment have informed policy development. Mobilization of volunteers and focused advocacy activities have brought about expansion of screening opportunities for newborns across the United States. But more work is needed. Continued application of the effective strategies identified in this report will help assure that all families have the best possible chance of assuring that their newborns do not have to suffer the complications of conditions that we know can be treated effectively.

The revival of death: expression, expertise and governmentality.

This paper discusses Walter's (1994) assertion that death in the West has recently undergone a revival. In particular it focuses on his claim that this revival is composed of two different strands: a late modern strand and a postmodern strand. The former, according to Walter, is driven by experts who seek to control death, the latter by ordinary people who seek to express their emotions freely. Describing the history and work of Cruse Bereavement Care, the largest bereavement counselling organization in the UK, we question Walter's distinction. We then problematize Walter's suggestion that the revival of death is caused by general social transformations. In contrast we evoke Rose's (1996) work on 'subjectification' and seek to link recent changes in the management of death and grief to permutations in governmental rationality.