Almeida C. Equidade e reforma setorial na América Latina: um debate necessário. [Equity and sectoral reform inLatin America: a necessary debate.] Cadernos de Saúde Pública [Public Health Notebooks] (Rio de Janeiro, Brazil) 2002; 18 (Suppl.): 23-36.

Objectives: To delve deeply into health policy in the context of social policies; to qualify the type of reforms discussed and the place that equity occupies in these reforms.

Methodology: Analytic and interpretive.

Results: “Reform” and “equity” are terms that frequently are presented in political discourses, technical documents, and conceptual discussions during the last decades in distinct proposals with different ideological references.

The author analyzes extensively the concepts of reform and equity, based on the contributions of different authors in the field of social sciences and on the definitions used in health reforms. Later, Almeida reviews the concepts of social policy and health policy, to analyze subsequently the central elements in the agenda of reform in health systems of the region.

Recent reforms have exacerbated inequalities and created new problems, substituting values of opportunity for “radical utilitarian individualism” rather than those of solidarity and equality. Likewise, the reforms substituted the principle of “health need” by that of “risk,” measured monetarily and defined according to the social and economic position of the individual.

Conclusions: The author argues that it is indispensable to return to a discussion of social and health policies as a matrix of principles that justify the ordering of any other policy, such as policies directed to the economy.

Copyright 2007 University of New Mexico