Relações interorganizacionais na área pública: condições necessárias para a criação de uma rede para a regulação do mercado de saúde suplementar do estado do Rio Grande do Sul

摘要

Network structures in the public sector are increasing significantly, creating a new administrative reality due to the new relationships that are established between state and society as well as with government-related organizations (LOIOLA; MOURA, 1996). In the context of the Brazilian public sector, however, this theme has been little explored in spite of its vast field of application, especially in the implementation of public policies. In this sense, regulatory politics are characterized as a favorable area for network action, such as the case of the supplementary health sector. This sector can be organized in various forms and promote relationships among diverse fields, making regulation possibilities extremely diversified (SANTOS, 2006). The public institution responsible to act directly in the regulation of this sector is the National Agency of Supplementary Health, in conjunction with other public organs such as PROCON, Ministério Público, Defensoria Pública and the Judiciary. At the moment, the aforementioned organs are not integrated; lack of information, the absence of coordination mechanisms, and the superposition of functions are common. Thus, the objective of the present study is to analyze the necessary conditions for the creation of a network between public organs that participate, directly or indirectly, in the regulatory process of the supplementary health market in Rio Grande do Sul. To meet this objective, qualitative exploratory research was conducted, using the single case study as an investigation strategy. Data were collected via in-depth interviews with managers of each public organ involved in the process of supplementary health regulation, and collated using content analysis. The study was conducted using a basis of nine proposed categories of necessary conditions for creation of the network – receptivity, stimulus, confidence, cooperation, political support, technical-operational support, articulating organization, coordination instruments, and constant and lasting interaction – which were obtained through analysis of the sector and a literature review of interorganizational and public networks. The results indicated that participants visualize possible gains through network action, such as greater efficiency of the involved public organs and effectiveness of the regulation process in supplementary health. Yet they also indicated that participants do not properly comprehend the concepts that involve network action, implicating the necessity of knowledge realignment around this theme within the public organs involved. The “Receptivity” category, the willingness of public organs to act in network, was the necessary condition most highlighted; it was also noted that individual and institutional egos can be barriers to receptivity. We see the need to adjust our proposed categories, as in the case of “Articulating Organization” which was not accepted by participants. Finally, participants raised several relevant issues outside the scope of our categories that should be considered in the process of network formation.