Regionalization and access to healthcare in Brazilian states: historical and political-institutional conditioning factors

This article examines the healthcare regionalization process in the Brazilian states in the period from 2007 to 2010, seeking to identify the conditions that favor or impede this process. Referential analysis of public policies and especially of historical institutionalism was used. Three dimensions sum up the conditioning factors of regionalization: context (historical-structural, political-institutional and conjunctural), directionality (ideology, object, actors, strategies and instruments) and regionalization features (institutionality and governance). The empirical research relied mainly on the analysis of official documents and interviews with key actors in 24 states. Distinct patterns of influence in the states were observed, with regionalization being marked by important gains in institutionality and governance in the period. Nevertheless, inherent difficulties of the contexts prejudice greater advances. There is a pressing need to broaden the territorial focus in government planning and to integrate sectorial policies for medium and long-term regional development in order to empower regionalization and to overcome obstacles to the access to healthcare services in Brazil.

Liberalism, Marxism and Democratic Theory Revisited: Proposal of a Joint Index of Political and Economic Democracy

Liberalism and Marxism are two schools of thought which have left deep imprints in sociological, political and economic theory. They are usually perceived as opposite, rival approaches. In the field of democracy there is a seemingly insurmountable rift around the question of political versus economic democracy. Liberals emphasize the former, Marxists the latter. Liberals say that economic democracy is too abstract and fuzzy a concept, therefore one should concentrate on the workings of an objective political democracy. Marxists insist that political democracy without economic democracy is insufficient. The article argues that both propositions are valid and not mutually exclusive. It proposes the creation of an operational, quantifiable index of economic democracy that can be used alongside the already existing indexes of political democracy. By using these two indexes jointly, political and economic democracy can be objectively evaluated. Thus, the requirements of both camps are met and maybe a more dialogical approach to democracy can be reached in the debate between liberals and Marxists. The joint index is used to evaluate the levels of economic and political democracy in the transition countries of Eastern Europe.