SOCIAL POLICY AS REGIONAL POLICY: MARKET AND NONMARKET FACTORS DETERMINING REGIONAL INEQUALITY

We decompose the recent changes in regional inequality in Brazil into its components, highlighting the role of spatially blind social programs. We aggregate personal income micro data to the state level, differentiating nine income sources, and assess the role of these components in the observed changes in regional inequality indicators. The main results indicate that the largest part of the recent reduction in regional inequality is related to the dynamics of the market-related labor income, with manufacturing and services favoring deconcentration. Labor income in agriculture, retirement and pensions, and property rents and other sources favored concentration. The social programs Bolsa Familia and Beneficios de Prestacao Continuada are responsible for more than 24 percent of the reduction in inequality, although they account for less than 1.7 percent of the disposable household income. Such positive impact on regional concentration is impressive, since the goals of the programs are clearly nonspatial.

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.