Universalização do acesso à saúde e regulação dos planos privados de assistência à saúde: a atuação regulatória da ANS como instrumento de harmonia contratual e viabilização do papel suplementar da iniciativa privada na efetivação do direito social à saúde

While essential to human nature, health and life have been protected since ancient times by various areas of knowledge, particularly by the Law, given its dynamics within the regulation of social interactions. In Brazil, health has been granted major importance by the Federal Constitution of 1988, which, disrupting the dictatorial authoritarianism, inaugurating a Social State and focusing on the values of freedom and human dignity, raises health to the condition of a social right, marked predominantly by an obligational bias directed, primarily, to the State, through the enforcement of public policies. Although, given the limitation of the State action to the reserve for contingencies, it turns clear that an universalizing access to public health is impossible, seen that the high cost of medical provisions hinders the State to meet all the health needs of the rightholders. As a result of the inefficiency of the State, the effort of the Constituent Assembly of 1988 in creating a hybrid health system becomes nuclear, which, marked by the possibility of exploration of healthcare by the private initiative, assigns to the private enterprise a key role in supplementing the public health system, especially through the offer of health insurance plans. At this point, however, it becomes clear that health provisions rendered by the private agents are not unlimited, which involves discussions about services and procedures that should be excluded from the contractual coverage, for purposes of sectoral balance, situation which draws the indispensability of deliberations between Fundamental Rights on one hand, related to the protection of health and life, and contractual principles on the other hand, connected to the primacy of private autonomy. At this point, the importance of the regulation undertaken by the ANS, Brazilian National Health Agency, appears primordial, which, by means of its seized broad functions, considerable autonomy and technical discretion, has conditions to implement an effective control towards the harmonization of the regulatory triangle, the stability and development of the supplementary health system and, consequently, towards the universalization of the right to health, within constitutional contours. According to this, the present essay, resorting to a broad legislative, doctrinal and jurisprudential study, concludes that economic regulation over the private healthcare sector, when legitimately undertaken, provides progress and stability to the intervening segment and, besides, turns healthcare universalization feasible, in a way that it can not be replaced efficiently by any other State function.

Promoção, vencimento e avaliação de desempenho do professor do ensino fundamental: o PCCR da rede municipal de ensino de Natal/RN (2004-2010)

This study is about the enhancement of the elementary school in Natal/RN, (PCCR - Law No. 058/2004), concerning to the horizontal promotion through the performance evaluation. It uses as reference the education policy on the legislative field hegemony and the managerial model. The analysis of the teacher´s valorization is based on the policy of Funds (Fundef and Fundeb) in the Brazilian social and educational agenda. The study focuses on the Career Plan, Career and Remuneration of teachers in the period (2004-2010).The study focuses on the Career Plan, Career and Remuneration of teachers in the period (2004-2010). The thesis argues for the necessity to adopt a direct relationship between career development and horizontal promotion for more others fifteen classes, no matter to any conditioning variables. In addition, the performance shall be evaluated by interval of 25 years to reach at least the provisions decided in the law, which determines the salary adjustment in 5% at every two years, as pointed at the PCCR, about teachers remuneration, and teachers qualifications. A work of a bibliographic and a documental review about the education funding with the purpose of enhancement of educational work, career concepts, and also promotion and evaluation performance as well was performed based on experts authors in this field. The survey was organized with the aim of articulating quantitative and qualitative information, analyzing data from the teacher's salary - payrolls and paychecks - also applying a questionnaire. After the implementation of the PCCR, it was found that the wage indices for horizontal promotion during the teaching career are tied to a strategy for evaluating the performance which disqualifies the teacher‟s salaries in a minimum percentage of 25% (up to 25 years) and there are also elements that disturb the promotion strategy. The national minimum wage was set in three salaries by the PSPN Lei nº11.738/2008 but it never reaches the three salaries at Natal/RN educational system.Otherwise, the elements that structure the horizontal promotion in fifteen classes, throughout the career, flout the minimum years of teaching work, long established in 25 years. In addition, changes in terms in the salary increase depend on individual efforts by professional development through titration. Concerning to the career, despite of the category approving its PCCR, neither this instrument nor the Funds Policy managed to establish regulations were able to cope effective rules for valuing the teachers in the educational district system. It is necessary to ensure, in percentage terms and financial, the real remuneration of teachers with the attainment of horizontal promotion, reviewing the elements that structure the career and the determinants of performance evaluation.