The Brazilian National Health Agency and the Mental Health Policy in the Context of the Private Health System: developments and challenges

This work analyses the mental health policy-making activity of the Brazilian National Health Agency (ANS), responsible for controlling health insurance companies. Three points are discussed: a) the framework of an economic and private health assistance regulatory activity, b) the ANS and its regulation activity and c) the rules produced by ANS in the mental health care field. It was concluded that, despite advances like the legal obligation to ensure medical treatment to all the diseases listed in ICD-10, the inclusion of suicidal patient damage and self-inflicted damage care, care provided by a multiprofessional team, the increase in the number of sessions with a psychologist, with an occupational therapist and of psychotherapy sessions, and mental health day hospitals included as part of the services offered, the authors identified specific regulatory gaps in this area. Some issues that ANS has to solve so that it can really play its institutional role of defending the public interest in the private health system are: the regulation of co-participation and franchise mechanisms, the increasing co-participation as a limitation of psychiatric hospitalization, and the limited number of crisis intervention psychotherapy sessions.

TITANS OF CAPITALISM IN THE MODERNIZATION OF BRAZILIAN TERRITORY: URBAN AND AWARDS PUBLIC ASSISTANCE DURING THE FIRST REPUBLIC (1889-1930)

In Brazil, the newly created Republic expressed interests of the elite increasingly committed to foreign capital. The Rio de Janeiro saw accumulate vast resources in trade and finance, deriving for industrial applications. The city appears as articulator of Brazilian territory and mediation between it and the international market. In the capital of the Republic, the conservative plan would sweep the old city and inaugurate images copied from Europe and installed in the tropics with civilizing purpose. This materialized with infrastructure financing and loans to entrepreneurs in Europe and North America, awarded public service concessions. The project relied on strong support of mayors (members or representatives of the companies involved in the reforms). This work aims to address the relationship between the mayors of Rio de Janeiro during the First Republic and international capital, focusing on strategies for the production of new spaces in motion the modernization of Brazil and its international image.