A formação do campo da saúde suplementar no Brasil

The aim of the present study is to analyze the evolution of the historical and institutional elements that generate the current design of the private health market in Brazil. Its main theoretical basis is the Theory of the Symbolic Power, by Pierre Bourdieu, complemented, in the non-conflictive aspects of these two visions, by the Anthony Giddens¿ institutional vision on the field genesis motivational factors. The research¿ data were collected through documents and semi structured interviews during 2002 e 2003 period, involving the qualitative analyze due to understand the field¿s phenomena under an actors¿ perspective. The research identifies the several players that integrate the market, their evident strategic goals, and those that are not so, besides of the powers¿ resources used to reach them, by DiMaggio and Powell¿ vision. Thus, it tries to show, through a historic linear description, and emphasis in the determinant facts, the evolution of the market¿s constitution. The study demonstrates that the field had formed from several Estate¿ actions, basically after the past seventy¿ decade, as result of a alternative Government¿ strategy towards a Brazilian population¿s dissemination plan of health¿ services that enforced the institutionalization of isomorphic structures, with a strong internal interaction and a hierarchy between kinds of values, that had emphasized the health¿ symbol as a citizenship¿s value. In the end, the study estimates that the crescent longevity¿ Brazilian¿s population and the consequent work¿s dismiss may cause a private health¿ elitism conforming a future problem in this sensible segment of the social politics of the Brazilian government.

International civil society actors in Genetically Modificied Organisms as a field of struggle: a neo-gramscian study in Brazil and the United Kingdom

Since the international financial and food crisis that started in 2008, strong emphasis has been made on the importance of Genetically Modified Organisms (GMOs) (or “transgenics”) under the claim that they could contribute to increase food productivity at a global level, as the world population is predicted to reach 9.1 billion in the year 2050 and food demand is predicted to increase by as much as 50% by 2030. GMOs are now at the forefront of the debates and struggles of different actors. Within civil society actors, it is possible to observe multiple, and sometime, conflicting roles. The role of international social movements and international NGOs in the GMO field of struggle is increasingly relevant. However, while many of these international civil society actors oppose this type of technological developments (alleging, for instance, environmental, health and even social harms), others have been reportedly cooperating with multinational corporations, retailers, and the biotechnology industry to promote GMOs. In this thesis research, I focus on analysing the role of “international civil society” in the GMO field of struggle by asking: “what are the organizing strategies of international civil society actors, such as NGOs and social movements, in GMO governance as a field of struggle?” To do so, I adopt a neo-Gramscian discourse approach based on the studies of Laclau and Mouffe. This theoretical approach affirms that in a particular hegemonic regime there are contingent alliances and forces that overpass the spheres of the state and the economy, while civil society actors can be seen as a “glue” to the way hegemony functions. Civil society is then the site where hegemony is consented, reproduced, sustained, channelled, but also where counter-hegemonic and emancipatory forces can emerge. Considering the importance of civil society actors in the construction of hegemony, I also discuss some important theories around them. The research combines, on the one hand, 36 in-depth interviews with a range of key civil society actors and scientists representing the GMO field of struggle in Brazil (19) and the UK (17), and, on the other hand, direct observations of two events: Rio+20 in Rio de Janeiro in 2012, and the first March Against Monsanto in London in 2013. A brief overview of the GMO field of struggle, from its beginning and especially focusing in the 1990s when the process of hegemonic formation became clearer, serves as the basis to map who are the main actors in this field, how resource mobilization works, how political opportunities (“historical contingencies”) are discovered and exploited, which are the main discourses (“science” and “sustainability” - articulated by “biodiversity preservation”, “food security” and “ecological agriculture”) articulated among the actors to construct a collective identity in order to attract new potential allies around “GMOs” (“nodal point”), and which are the institutions and international regulations within these processes that enable hegemony to emerge in meaningful and durable hegemonic links. This mapping indicates that that the main strategies applied by the international civil society actors are influenced by two central historical contingencies in the GMO field of struggle: 1) First Multi-stakeholder Historical Contingency; and 2) “Supposed” Hegemony Stability. These two types of historical contingency in the GMO field of struggle encompass deeper hegemonic articulations and, because of that, they induce international civil society actors to rethink the way they articulate and position themselves within the field. Therefore, depending on one of those moments, they will apply one specific strategy of discourse articulation, such as: introducing a new discourse in hegemony articulation to capture the attention of the public and of institutions; endorsing new plural demands; increasing collective visibility; facilitating material articulations; sharing a common enemy identity; or spreading new ideological elements among the actors in the field of struggle.