Regulation in the public health sector in Brazil: the (mis) direction of hospital care provision

Health care regulation is a fundamental action in order to achieve effectiveness in health system. This article analyses SUS [Unified Health System] main regulatory framework, in relation to historical patterns of health service delivery, observed between 1996 and 2006. Despite all those political and organizational changes required by the Brazilian health sector reform process to implement SUS, which progressed, evidences and empirical data suggest that the agreed regulatory frameworks are weak and fragile and they did not change historical patterns and the main characteristics of SUS health care. This article suggests one possible explanatory reason for this behaviour, that needs to be empirically analysed: interest groups acting inside the Brazilian health system, on behalf of social insurance health care network, could capture the regulatory process, taking public resources to this network which maintain the same pattern of heath care services for decades, jeopardizing SUS implementation and the relevant health service delivery for the Brazilian society.