International capital companies and the Brazilian health system: a study on renal replacement therapy

Since the liberalization of foreign capital in health a new trend has arisen in the process of capital accumulation in the industrial economic complex of health, especially at the levels of outsourced care and Services of Care, Treatment and Diagnosis (SCTD). In order to contribute to the understanding of this dynamic, this article sought to analyze the acquisition process of Renal Replacement Therapy (RRT) clinics by international capital companies in Brazil. To achieve this, a two-stage methodological path was developed; the first consisted in the quantitative-descriptive analysis of the economic type of all the international capital companies that operate in the production of input and technologies and in RRT care services; the second was developed by a qualitative analysis of semi-structured interviews of key actors from the private and public sectors and organized civil society. Therefore, the process of the advance of international capital brings with it a qualitative change in the organization, assistance and financing of RRT. It can be seen that, especially in the cases of complementary public and private services, there is a tendency to restrict care and create an obstacle to the universal right to health.