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      Capital financiero versus complejo médico-industrial: los desafíos de las agencias regulatorias Translated title: Financial capital versus medical-industrial complex: challenges for the regulatory agencies

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          Abstract

          Se presentan los procesos estructurales consolidados en los 90s bajo la hegemonía del capital financiero; las pujas distributivas generadas con el complejo médico-industrial; las estrategias que éste usó para reposicionarse; y los desafíos que enfrentan las agencias regulatorias estatales. Dos procesos son fundamentales para ubicar la problemática que enfrentan las agencias regulatorias: 1) La hegemonía alcanzada en los 90s por el capital financiero en el sector salud, vía las reformas destinadas a desregularlo; y 2) el reposicionamiento del complejo médico-industrial desde mediados de los 90s, a través de radicalizar la medicalización. Este artículo se basa en varias investigaciones conducidas por la autora en las que se usaron métodos cualitativos y datos secundarios cuantitativos para la contextualización histórico-situacional. El abordaje teórico se basó en Marx, Gramsci, Benasayag, Badiou, Testa y Merhy. El análisis de las reformas más recientes impulsadas por el complejo médico-industrial es producto de una investigación bibliográfica y documental.

          Translated abstract

          This article presents the structural processes that consolidated under the hegemony of the financial capital in the 90s; the dispute between the financial capital operating in the health sector and the medical-industrial complex; the strategies used by the medical-industrial complex for regaining positions; and the challenges all these processes pose for the regulatory agencies. The problems the regulatory agencies are facing lie in two central processes: 1) the hegemony the financial capital reached in the 90s in the health sector through reforms aimed at deregulating the sector in order to facilitate its entrance; and 2) the repositioning of the medical-industrial complex since the mid 90s by radicalizing medicalization. This article is based on several studies conducted by the author using qualitative methods and quantitative secondary data for understanding the historical-situational context. The theoretical approach was based on Marx, Gramsci, Benasayag, Badiou, Testa and Merhy. The analyses of the most recent reforms induced by the medical-industrial complex were the result of a bibliographic and document review.

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          Most cited references17

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          The philosophical limits of evidence-based medicine.

          M. Tonelli (1998)
          Evidence-based medicine (EBM) has already had a profound effect on both medical education and clinical practice. The benefits of EBM, which defines the value of medical interventions in terms of empirical evidence from clinical trials, are enormous and well described. Not clearly acknowledged, however, are the limits of EBM. An intrinsic gap exists between clinical research and clinical practice. Failure to recognize and account for this gap may lead to unintended and untoward consequences. Under the current understanding of EBM, the individuality of patients tends to be devalued, the focus of clinical practice is subtly shifted away from the care of individuals toward the care of populations, and the complex nature of sound clinical judgment is not fully appreciated. Despite its promise, EBM currently fails to provide an adequate account of optimal medical practice. A broader understanding of medical knowledge and reasoning is necessary.
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            Female Sexual Dysfunction: A Case Study of Disease Mongering and Activist Resistance

            Tiefer highlights key steps in the "creation" of a new diagnosis, female sexual dysfunction, and of the campaign to challenge its reductionist approach to women's sexual problems.
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              The exportation of managed care to Latin America.

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                Author and article information

                Journal
                csc
                Ciência & Saúde Coletiva
                Ciênc. saúde coletiva
                ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro, RJ, Brazil )
                1413-8123
                1678-4561
                October 2008
                : 13
                : 5
                : 1619-1626
                Affiliations
                [01] Albuquerque orgnameUniversity of New Mexico orgdiv1Center for Health Policy orgdiv2Department of Family and Community Medicine United States
                Article
                S1413-81232008000500025 S1413-8123(08)01300525
                10.1590/S1413-81232008000500025
                872e2efd-40cd-4489-bbac-2d8572bf0c97

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 12 March 2008
                : 07 February 2008
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 37, Pages: 8
                Product

                SciELO Public Health

                Self URI: Texto completo solamente en formato PDF (ES)

                Health sector reform,Latin America,Financial capital,Medical-industrial complex,Distribution dispute,Regulation,Reforma del sector salud,América Latina,Capital financiero,Complejo médico-industrial,Puja distributiva,Regulación

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