ABSTRACT
The political process of the modern Brazilian Sanitation Reform has been haunted by a phantom since its beginning, in the 1970s: the so-called ‘ghost of the absent class’, which intends to designate the little participation of the masses in the fights and claimings for health. Brazilian sanitarists had the popular participation experience of the Italian Sanitation Reform as a reference and it was precisely from it that emerged a certain strangeness to the Brazilian case. The history of the phenomenon, however, is inscribed in the dilemmas experienced by the Brazilian working class as a whole, which was under a process of strategic transition then. It is also due to the tactical choices made by the sanitarists to achieve the political objectives of Brazilian Sanitation Movement. We conclude that the organizational and combative retreat of the class is part of the historical defeat suffered when the socialist block fell, in the turn of the 1980s. The overcoming of both the defeat and the phantom will only be accomplished through the resumption of the struggle from the base, crossing sectoral boundaries and breaking with the fetishization of the State as a means to the full emancipation of the workers; and through the restoration of the bourgeois ‘democratic’ order as a rightful locus of political struggle.
KEYWORDS
Health care reform; Public policy; Unified Health System