Ana Carolina Cordilha - Profile on Academia.edu (original) (raw)

Books by Ana Carolina Cordilha

Research paper thumbnail of The financialization of social policy: an overview

Handbook on Critical Political Economy and Public Policy, 2024

In this chapter, we examine how financialization is reshaping the purpose, design, and delivery o... more In this chapter, we examine how financialization is reshaping the purpose, design, and delivery of social policy under contemporary capitalism. We argue that social policy is increasingly organized around financial logics, institutions, and instruments, shifting its role from promoting socioeconomic security and collective welfare to facilitating financial accumulation. One of our central contributions is to show how this transformation reconfigures the relationship between the state, households, and markets, particularly through mechanisms like debt, microcredit, and the use of cash transfers as financial collateral. We clarify how financialization affects both the supply and demand sides of social provision across pensions, education, and health by subordinating them to investor interests and market imperatives. We highlight how social policy now acts as a platform for financial expansion, creating new sites of extraction in areas traditionally governed by public provision. This shift, we argue, deepens social inequalities and increases household vulnerability, especially in the Global South. Our analysis brings attention to the state's active role in enabling these processes through regulatory change, credit programs, and infrastructure financing. In doing so, we offer a framework for understanding financialization as more than an economic trend: it is a political restructuring of welfare and social reproduction. We call for renewed scrutiny of how financialized regimes reshape social rights and the future of public policy.

Research paper thumbnail of Financiarisation

Dictionnaire politique de l’Amérique latine Financiarisation - Éditions de l’IHEAL, 2024

This article offers an accessible explanation of financialization as the growing power of financi... more This article offers an accessible explanation of financialization as the growing power of financial actors over public policies and everyday life. It focuses on how Latin America's subordinate position in the global financial system may exacerbate this dynamic. Through concrete examples such as underfunded public health systems and the financial takeover of agricultural land, it shows how finance may redirect public resources and natural assets toward profit-making. The text highlights how governments may reshape budgets to satisfy creditors rather than meet social needs and suggests that financialization may erode democratic control and harm both people and ecosystems.

Cet article propose une explication accessible de la financiarisation comme emprise croissante des acteurs financiers sur les politiques publiques et la vie quotidienne. Il montre comment la position subordonnée de l’Amérique latine dans le système financier mondial peut aggraver cette dynamique. À travers des exemples concrets comme le sous-financement de la santé publique et l’appropriation foncière par des fonds d’investissement, il met en lumière comment la finance peut orienter les ressources publiques et naturelles vers des logiques de profit. Le texte souligne que les gouvernements peuvent réorganiser leurs budgets pour répondre aux exigences des créanciers plutôt qu’aux besoins sociaux, et suggère que la financiarisation pourrait affaiblir le contrôle démocratique et nuire aux populations comme aux écosystèmes.

Research paper thumbnail of Impondo restrições, oferecendo soluções: como a financeirização pautou a trajetória do sistema público de saúde (SUS) no Brasil

Financeirização: crise, estagnação e desigualdade, 2024

The article examines how financialization has shaped the funding and structure of Brazil’s Unifie... more The article examines how financialization has shaped the funding and structure of Brazil’s Unified Health System (SUS) since its creation. It shows that fiscal and monetary policies have placed the SUS in service of financial accumulation strategies, compromising its long-term financing. The text also highlights how the system increasingly turns to the financial sector such as through bank loans backed by future public payments to sustain service provision. By adopting the concept of state financialization, the article proposes an original framework for understanding the impact of expanding financial logics on social policy. It suggests that such dynamics may weaken the democratic and redistributive principles at the core of the SUS.

O artigo analisa como a financeirização tem moldado o financiamento e a organização do Sistema Único de Saúde (SUS) no Brasil desde sua criação. Mostra que decisões de política fiscal e monetária colocam o SUS a serviço de estratégias de acumulação financeira, comprometendo seu financiamento de longo prazo. Também demonstra como o sistema tem recorrido ao setor financeiro, por exemplo, por meio de empréstimos bancários consignados, para viabilizar a prestação de serviços públicos. Ao utilizar o conceito de financeirização do Estado, o texto oferece uma abordagem inovadora para compreender os efeitos da expansão financeira sobre políticas sociais. Sugere-se que essa dinâmica pode enfraquecer os princípios democráticos e redistributivos que orientam o SUS.

Research paper thumbnail of Public Health Systems in the Age of Financialization: Lessons from the Center and the Periphery

Brill, 2023

In Public Health Systems in the Age of Financialization, I unpack policy shifts that have transfo... more In Public Health Systems in the Age of Financialization, I unpack policy shifts that have transformed public health systems into vehicles for financial speculation and capital accumulation. While it is commonly thought that these systems are being cut back in the period of financialization, I show that current changes in public health financing go far beyond budget cuts and privatization measures. I examine how public health systems are adopting financial instruments and participating in financial accumulation strategies, with harmful impacts on transparency, democratic accountability, and health service provision. With an in-depth study of both the French and Brazilian systems, I explore the different ways in which this process unfolds in central and peripheral countries.

Publications by Ana Carolina Cordilha

Research paper thumbnail of Financialisation and Public Health Systems: a new concept to examine ongoing reforms

Économie et institutions, 2022

This article introduces financialization as a critical concept for analyzing contemporary reforms... more This article introduces financialization as a critical concept for analyzing contemporary reforms in public health systems (PHS). It argues that financialization offers a distinct analytical lens that complements and goes beyond established notions such as privatization. A central contribution of the paper is clarifying the conceptual boundaries between financialization and privatization, two terms that are often conflated in the health policy literature. The study shows that while both processes respond to fiscal constraints and promote market-based reforms, financialization brings in new actors, such as global investors and financial intermediaries, and transforms public financing mechanisms in unique ways. It also highlights how financialization can exacerbate the challenges previously associated with privatization, including reduced transparency, increased inequality, and diminished democratic control. The paper encourages the incorporation of financialization into the conceptual toolkit of health policy research seeking to open up new directions for investigating the political economy of health and the evolving role of the state in service provision.

Research paper thumbnail of Private Financial Actors and Financialisation in Global Health

Private Financial Actors and Financialisation in Global Health Power & Accountability Briefing Paper, 2025

This briefing paper responds to the expansion of private finance in global health, demystifying t... more This briefing paper responds to the expansion of private finance in global health, demystifying the process of financialisation and offering a vital counter-perspective to an increasingly pervasive but questionable narrative that positions private finance as necessary to the future of global health. The paper charts the expansion of private finance across global health, pointing to how actors once marginal to this sector are becoming central to its financing and governance. Drawing on several case studies and a growing body of evidence, the briefing paper highlights three overlapping concerns associated with the financialisation of global health: the high cost of private investment; the undermining of public health principles and values; and the weakening of democratic governance and regulatory capture by powerful private financial actors.

Research paper thumbnail of Public health systems in the age of financialization: lessons from France and Brazil

Doctoral Thesis, Sorbonne Paris Nord University, 2022

Contemporary capitalism is underpinned by the process of financialization - the expansion of the ... more Contemporary capitalism is underpinned by the process of financialization - the expansion of the financial sector in size, scale, and power. Although this process is a key driver of transformations in the global economy, the mechanisms through which it reshapes Public Health Systems (PHS) remain poorly investigated. This thesis contributes to a better understanding of transformations in PHS by reassessing their trajectory from the fresh analytical framework of financialization. Incorporating this concept sheds light on actors, instruments, processes, and interests that have been critical in shaping reforms but which remain partially misapprehended.We hypothesize that PHS are being reshaped by the process of financialization in ways that are functional for the expansion of the financial sector and the accumulation of financial capital. To investigate this hypothesis, we combine a theoretical discussion with an empirical investigation of two universal health systems, in France and Brazil. Following a mixed-method approach that combines qualitative and quantitative information, we demonstrate the implementation of financialized policies in each PHS since the 1990s. This means policies leading them to adopt financial logics, engage with financial instruments, and participate in financial accumulation strategies.The first chapter introduces the topic of financialization and the inroads of finance into social provision. The second chapter conceptualizes PHS and suggests how to incorporate the notion of financialization into the analysis. The third and fourth chapters present the empirical findings. The conclusion systematizes these findings and elaborates a critical discussion on the problems associated with the adoption of financialized policies. We show that these policies transform PHS into vehicles for financial accumulation, decrease the stability of funding, and pose serious problems to democratic participation

Research paper thumbnail of Public health systems in the age of financialization: lessons from the French case

Review of Social Economy, 2021

Public Health Systems (PHS) are under continuous transformation in line with economic, political,... more Public Health Systems (PHS) are under continuous transformation in line with economic, political, and ideological changes in capitalist economies. The current stage of capitalism is underpinned by the process of financialization, meaning an increasing dominance of financial actors, markets, practices, measurements, and narratives over other agents, including the State. This article examines how financialization has been reshaping PHS, with an in-depth study of the French case. First, we suggest how to incorporate the concept of financialization into the research on PHS transformation. We then apply this concept to reassess the trajectory of the French system from the 1990s onwards. We show the increasing participation of financial capital for long-term, short-term, and infrastructure financing, occupying roles previously fulfilled by the public sector. We then discuss how the adoption of financialized strategies led to shifts in how public actors behave, and the potentially adverse effects for solidarity, stability, and democratic participation.

Research paper thumbnail of Protecting People Or Finance? On the Need To Free Social Policies From Financial Markets During And After Crises

EPOG Policy Briefs, 2020

Through the French case, this policy brief uncovers the promises and perils of making social poli... more Through the French case, this policy brief uncovers the promises and perils of making social policies dependent on financial markets, especially during crises. It discusses alternatives that are better suited for fostering social wellbeing and economic stability in the long run.

Research paper thumbnail of How Financialization Reshapes Public Health Care Systems : The Case of Assurance Maladie

CEPN Working Papers 03-2020, 2020

This article seeks to show how financialization is reshaping Public Health Care Systems (PHCS). T... more This article seeks to show how financialization is reshaping Public Health Care Systems (PHCS). To do so, we combine a theoretical discussion and an empirical investigation to examine the increasing participation of financial actors and instruments in these systems over the last decades. In the first part, we present the conventional approach for assessing PHCS transformation to date and argue for the need to incorporate the concept of ’financialization’. In the second part, we suggest a method for empirically examining how financialization alters the internal structures and organization of PHCS. In the last part, we apply this method to conduct an in-depth analysis of the French public health system, Assurance Maladie (AM). Our findings provide robust evidence that financialization had a major influence in the direction taken by the post-1990s reforms in this case, with new strategies allowing the increased participation of financial capital in the system’s long-term, short-term, and investment financing. In the conclusion, we provide a critical assessment of financialized strategies, highlighting their adverse impacts on core principles of PHCS such as solidarity, stability, and democratic participation.

Research paper thumbnail of The reshaping of healthcare systems in the age of financialization. Lessons from France and Brazil. / Transformações dos sistemas de saúde na era da financeirização. Lições da França e do Brasil

Revista Ciência e Saúde Coletiva, 2018

(English version) Since the post-War period, social protection systems have experienced continuou... more (English version)
Since the post-War period, social protection systems have experienced continuous reforms , either extending or, more often, reducing the scope and the scale of public provision. This paper seeks to present how healthcare systems have evolved both in France and in Brazil recently , in order to comprehend mechanisms through which financialization has been reshaping public care provision. This comparative analysis unveils distinct financialization dynamics of healthcare systems, built upon universalism principles. After featuring both systems, underlying their private dimension – either complementary or supplementary – the article points out how the financial sector is broadening its share in the supply of healthcare services. In what follows, the sector's process of internationalization/centralization is analyzed and lastly the regulatory role of the State in strengthening private provision is defined. Despite radically different institutional paths, the findings corroborate that in both cases finance is a driving force in reshaping the healthcare sector.

(Portuguese version)
Desde a segunda metade do século XX, reformas tornaram-se contínuas no âmbito dos sistemas de proteção social, ampliando ou, com mais frequência, restringindo o escopo e a escala da provisão pública. Neste artigo, cotejamos a evo-lução recente dos sistemas de saúde na França e no Brasil, de modo a apreender os mecanismos atra-vés dos quais a " financeirização " vem reforma-tando a provisão pública. Essa abordagem com-parada tem por finalidade explicitar dinâmicas diferenciadas de penetração do capital financeiro em sistemas de saúde que se pautaram por princí-pios universalistas. Após caracterizar brevemente ambos os sistemas de saúde, destacando o alcance da provisão privada seja complementar, seja su-plementar, o artigo mostra como o setor financeiro vem ampliando sua participação na oferta de ser-viços de saúde. Em seguida, analisa como se dá o processo de internacionalização/centralização do setor, e, finalmente, sintetiza o papel regulatório do Estado no fortalecimento da provisão privada. Os resultados indicam que, a despeito de trajetó-rias institucionais radicalmente opostas, a marcha da financeirização avança no setor de saúde.

Research paper thumbnail of Desoneração da folha de pagamentos: impactos na competitividade e política social

Master thesis at Federal University of Rio de Janeiro (text in Portuguese). Advisor: Prof. Lena L... more Master thesis at Federal University of Rio de Janeiro (text in Portuguese).
Advisor: Prof. Lena Lavinas

Desde os anos 90, as desonerações tributárias vêm se consolidando como um dos principais instrumentos do governo brasileiro para estimular a indústria nacional, que tem na desoneração da folha de pagamentos adotada no início do mandato de Dilma Rousseff em 2011 um de seus maiores exemplos recentes. Ao mesmo tempo em que tais medidas não se provam capazes de contrarrestar a visível perda de dinamismo do setor, implicam em uma renúncia crescente a receitas vinculadas ao financiamento da proteção social no país. Este trabalho se propõe a analisar os impactos da desoneração da folha sobre a competitividade e a política social brasileira, com base na trajetória das renúncias tributárias, exportações, importações e emprego em dois dos primeiros segmentos beneficiados pela medida, vestuário e couro/calçados. Os resultados corroboram a hipótese de que tal política, assim como as desonerações tributárias em geral aplicadas no Brasil, possuem uma natureza essencialmente “espúria” – isto é, incapazes de garantir ganhos econômicos sustentáveis e compatíveis com efetivo progresso social no longo prazo.

Research paper thumbnail of Asymétries de Genre sur le marché du travail au Brésil: les enjeux de la formalisation

Asymétries de Genre sur le marché du travail au Brésil: les enjeux de la formalisation

In: Nadya Araujo Guimaraes; Margaret Maruani; Bila Sorj (Org.). Genre, race, classe - Travailler ... more In: Nadya Araujo Guimaraes; Margaret Maruani; Bila Sorj (Org.). Genre, race, classe - Travailler en France et au Brésil. 1ed. Paris: Hartmann, 2016, v.1 p.111-133

Research paper thumbnail of Assimetrias de gênero no mercado de trabalho no Brasil: rumos da formalização.

Assimetrias de gênero no mercado de trabalho no Brasil: rumos da formalização.

In: Alice Rangel de Paiva Abreu, Helena Hirata e Maria Rosa Lombardi (Org.). Gênero e trabalho no... more In: Alice Rangel de Paiva Abreu, Helena Hirata e Maria Rosa Lombardi (Org.). Gênero e trabalho no Brasil e na França. Perspectivas interseccionais. 1 ed. São Paulo: Boitempo, 2016.

Research paper thumbnail of Income distribution and economic growth: unfolding different approaches on the Brazilian case

Master thesis at Université Paris 13. Advisor: Prof. Marc Lavoie Co-advisor: Prof. Gary Dimsky ... more Master thesis at Université Paris 13.
Advisor: Prof. Marc Lavoie
Co-advisor: Prof. Gary Dimsky

Abstract: This study systematizes relations between income distribution and economic growth on the Structuralist and Post-Keynesian schools of thought, using such contributions to discuss the evolution of the Brazilian economy in the last fifteen years, when redistribution policies gained a huge momentum as drivers of a new growth strategy. Based on the assumption of its “rise and fall” from 2000 to 2015, the main goal is to discuss possible explanations for such an evolution according to different frameworks of economic theory. Considering the observation of a change on income distribution in this period, this is done by comparing predicted outcomes of such process over economic growth with empirical results, using each particular framework to infer causal relations and explain eventual inconsistencies between theory and reality.
The first chapter presents different interpretations on how income redistribution affects economic growth (and other crucial elements of capitalist economies) according to two heterodox schools of thought, Structuralism and the post-keynesian theory of “growth regimes”.
The choice of these specific branches is justified not only by the centrality assumed by this relation in their theoretical frameworks as well as by the fact that they are two of the main references for
the discussion of the Brazilian case in recent times. The second chapter provides an empirical basis to discuss such interpretations, presenting the evolution of different economic and social indicators from 2000 to 2015. Finally, the last chapter uses the selected economic theories as a
background to discuss the outcomes observed during the period of an alleged shift on economic distribution. By recovering predicted causal relations and comparing it to what seems to have occurred in practice, it allows to identify potentially important obstacles for the establishment of a sustainable path of economic development based on a more fair redistribution of income in Brazil, as expected in the beginning of this period.

Research paper thumbnail of Desoneração da Folha de Pagamentos para Competitividade Espúria?

A Desoneração da Folha de Pagamentos adotada pelo governo Dilma vem sendo exaltada por grande par... more A Desoneração da Folha de Pagamentos adotada pelo governo Dilma vem sendo exaltada por grande parte dos setores público e privado como uma medida necessária e eficaz para promover a competitividade da indústria nacional, sofrendo contínua expansão desde o inicio de sua implementação em 2011: de 4 setores econômicos inicialmente beneficiados para mais de 50 em 2014. 1 Adotada sob caráter temporário, declarações do Ministério da Fazenda afirmam que a partir de 2015 a regra deve tornar-se permanente e ainda mais ampla, implicando uma renúncia de recursos que somente para este ano foi estimada em R$ 21,6 bilhões. 2 No entanto, seu caráter não é inovador: a concessão de benefícios tributários ao setor privado têm sido uma constante dentre as principais políticas de incentivo do governo brasileiro desde os anos 90, ganhando ainda mais destaque com sua ampla utilização para combate aos efeitos recessivos da crise internacional após 2008, e apoiando-se cada vez mais na renúncia a recursos destinados à Política Social. Este artigo procura relativizar as perspectivas de efetividade da política de desoneração da folha de pagamentos, dimensionando-a dentro da extensa trajetória de concessão de benefícios tributários como instrumento de estímulo econômico do governo brasileiro. Busca-se refletir sobre a natureza potencialmente espúria dos ganhos de competitividade associados a tais instrumentos – isto é, incapazes de garantir uma inserção internacional sustentável e com maior inclusão social. O argumento sustenta-se na ideia de que, embora os incentivos tributários tenham crescido desde o final do século XX, a persistência dos problemas de competitividade interna e externa enfrentados pela indústria brasileira (sinalizada pelo baixo crescimento da indústria de transformação, especialmente em setores expostos à concorrência internacional, e pela deterioração da Balança Comercial com crescente dependência dos produtos primários) parece indicar sua incapacidade em contrabalançar diversas forças contrárias à elevação da competitividade nacional, garantindo os resultados esperados. A primeira dimensão do caráter potencialmente espúrio dos ganhos decorrentes das desonerações tributárias, como a da folha de pagamentos, se daria pela manutenção de obstáculos sistêmicos que há décadas prejudicam a competitividade brasileira, conferindo-lhes assim efetividade duvidosa no longo prazo. A segunda dimensão, o conflito com o progresso social, fundamentar-se-ia pela concessão de benefícios ao setor privado apoiados em recursos próprios da Seguridade Social, instituição central para garantia de acesso a direitos universais básicos e redução da pobreza e desigualdade no Brasil.

Research paper thumbnail of Limites ao processo de redução das desigualdades sociais na América Latina

Paper published in Revista Brasileira de Estudos Latino-Americanos (text in Portuguese). Resumo ... more Paper published in Revista Brasileira de Estudos Latino-Americanos (text in Portuguese).

Resumo
A proposta deste artigo é analisar a estratégia de redução das desigualdades sociais característica de governos latino-americanos a partir da década de 2000 e suas possíveis limitações no que se refere à promoção efetiva de maior equidade social no longo prazo. Tais barreiras dar-se-iam principalmente devido (i) à expansão de um modelo neoliberal de Política Social, calcado na crescente focalização e mercantilização de bens e serviços essenciais; (ii) aos avanços no mercado de trabalho como fator de liderança do processo recente de inserção social, caminho vulnerável aos ciclos econômicos e restrito a uma parcela da população, em detrimento ao fortalecimento de sistemas institucionalizados de Proteção Social; e (iii) pela elevada fragilidade e/ou regressividade dos sistemas tributários da região.
Palavras-chave: América Latina, desenvolvimento econômico, desigualdade social, equidade.

Limits for the reduction of social inequalities in Latin America

Abstract
This paper analyzes strategies for reducing social inequalities by latin american governments since the 2000’s decade, as well as its possible limitations for promoting social equity in the long run. The argument is that such obstacles could emerge mainly due to (i) the expansion of a neoliberal model of Social Policy, increasingly based on targeting and commodification of essential goods and services; (ii) the leading role of labor market changes in the recent process of social inclusion at the expense of strengthening Social Protection Systems; (iii) highly fragile and/or regressive tax systems.
Key-words: Latin America, economic development, social inequality, social equity

Research paper thumbnail of É possível enfrentar o deficit fiscal combatendo a desigualdade? Recuperando o papel da política tributária

Book chapter. In: Luiz Gonzaga de Mello Belluzzo e Paulo Zahluth Bastos (Org.). Austeridade para ... more Book chapter. In: Luiz Gonzaga de Mello Belluzzo e Paulo Zahluth Bastos (Org.). Austeridade para quem? balanço e perspectivas do governo Dilma Rousseff. 1ed. São Paulo: Carta Maior/Friedrich Ebert, 2015,

Conference Presentations by Ana Carolina Cordilha

Research paper thumbnail of Brazil: ongoing reforms under a new wave of financialization

Presentation at the 8th Annual Conference in Political Economy (IIPPE)

Research paper thumbnail of Social Policies in " Financialized " Capitalism: Critical Interpretations on New Practices, Goals, And Outcomes

Presentation at the Festival For New Economic Thinking 2017

Research paper thumbnail of The financialization of social policy: an overview

Handbook on Critical Political Economy and Public Policy, 2024

In this chapter, we examine how financialization is reshaping the purpose, design, and delivery o... more In this chapter, we examine how financialization is reshaping the purpose, design, and delivery of social policy under contemporary capitalism. We argue that social policy is increasingly organized around financial logics, institutions, and instruments, shifting its role from promoting socioeconomic security and collective welfare to facilitating financial accumulation. One of our central contributions is to show how this transformation reconfigures the relationship between the state, households, and markets, particularly through mechanisms like debt, microcredit, and the use of cash transfers as financial collateral. We clarify how financialization affects both the supply and demand sides of social provision across pensions, education, and health by subordinating them to investor interests and market imperatives. We highlight how social policy now acts as a platform for financial expansion, creating new sites of extraction in areas traditionally governed by public provision. This shift, we argue, deepens social inequalities and increases household vulnerability, especially in the Global South. Our analysis brings attention to the state's active role in enabling these processes through regulatory change, credit programs, and infrastructure financing. In doing so, we offer a framework for understanding financialization as more than an economic trend: it is a political restructuring of welfare and social reproduction. We call for renewed scrutiny of how financialized regimes reshape social rights and the future of public policy.

Research paper thumbnail of Financiarisation

Dictionnaire politique de l’Amérique latine Financiarisation - Éditions de l’IHEAL, 2024

This article offers an accessible explanation of financialization as the growing power of financi... more This article offers an accessible explanation of financialization as the growing power of financial actors over public policies and everyday life. It focuses on how Latin America's subordinate position in the global financial system may exacerbate this dynamic. Through concrete examples such as underfunded public health systems and the financial takeover of agricultural land, it shows how finance may redirect public resources and natural assets toward profit-making. The text highlights how governments may reshape budgets to satisfy creditors rather than meet social needs and suggests that financialization may erode democratic control and harm both people and ecosystems.

Cet article propose une explication accessible de la financiarisation comme emprise croissante des acteurs financiers sur les politiques publiques et la vie quotidienne. Il montre comment la position subordonnée de l’Amérique latine dans le système financier mondial peut aggraver cette dynamique. À travers des exemples concrets comme le sous-financement de la santé publique et l’appropriation foncière par des fonds d’investissement, il met en lumière comment la finance peut orienter les ressources publiques et naturelles vers des logiques de profit. Le texte souligne que les gouvernements peuvent réorganiser leurs budgets pour répondre aux exigences des créanciers plutôt qu’aux besoins sociaux, et suggère que la financiarisation pourrait affaiblir le contrôle démocratique et nuire aux populations comme aux écosystèmes.

Research paper thumbnail of Impondo restrições, oferecendo soluções: como a financeirização pautou a trajetória do sistema público de saúde (SUS) no Brasil

Financeirização: crise, estagnação e desigualdade, 2024

The article examines how financialization has shaped the funding and structure of Brazil’s Unifie... more The article examines how financialization has shaped the funding and structure of Brazil’s Unified Health System (SUS) since its creation. It shows that fiscal and monetary policies have placed the SUS in service of financial accumulation strategies, compromising its long-term financing. The text also highlights how the system increasingly turns to the financial sector such as through bank loans backed by future public payments to sustain service provision. By adopting the concept of state financialization, the article proposes an original framework for understanding the impact of expanding financial logics on social policy. It suggests that such dynamics may weaken the democratic and redistributive principles at the core of the SUS.

O artigo analisa como a financeirização tem moldado o financiamento e a organização do Sistema Único de Saúde (SUS) no Brasil desde sua criação. Mostra que decisões de política fiscal e monetária colocam o SUS a serviço de estratégias de acumulação financeira, comprometendo seu financiamento de longo prazo. Também demonstra como o sistema tem recorrido ao setor financeiro, por exemplo, por meio de empréstimos bancários consignados, para viabilizar a prestação de serviços públicos. Ao utilizar o conceito de financeirização do Estado, o texto oferece uma abordagem inovadora para compreender os efeitos da expansão financeira sobre políticas sociais. Sugere-se que essa dinâmica pode enfraquecer os princípios democráticos e redistributivos que orientam o SUS.

Research paper thumbnail of Public Health Systems in the Age of Financialization: Lessons from the Center and the Periphery

Brill, 2023

In Public Health Systems in the Age of Financialization, I unpack policy shifts that have transfo... more In Public Health Systems in the Age of Financialization, I unpack policy shifts that have transformed public health systems into vehicles for financial speculation and capital accumulation. While it is commonly thought that these systems are being cut back in the period of financialization, I show that current changes in public health financing go far beyond budget cuts and privatization measures. I examine how public health systems are adopting financial instruments and participating in financial accumulation strategies, with harmful impacts on transparency, democratic accountability, and health service provision. With an in-depth study of both the French and Brazilian systems, I explore the different ways in which this process unfolds in central and peripheral countries.

Research paper thumbnail of Financialisation and Public Health Systems: a new concept to examine ongoing reforms

Économie et institutions, 2022

This article introduces financialization as a critical concept for analyzing contemporary reforms... more This article introduces financialization as a critical concept for analyzing contemporary reforms in public health systems (PHS). It argues that financialization offers a distinct analytical lens that complements and goes beyond established notions such as privatization. A central contribution of the paper is clarifying the conceptual boundaries between financialization and privatization, two terms that are often conflated in the health policy literature. The study shows that while both processes respond to fiscal constraints and promote market-based reforms, financialization brings in new actors, such as global investors and financial intermediaries, and transforms public financing mechanisms in unique ways. It also highlights how financialization can exacerbate the challenges previously associated with privatization, including reduced transparency, increased inequality, and diminished democratic control. The paper encourages the incorporation of financialization into the conceptual toolkit of health policy research seeking to open up new directions for investigating the political economy of health and the evolving role of the state in service provision.

Research paper thumbnail of Private Financial Actors and Financialisation in Global Health

Private Financial Actors and Financialisation in Global Health Power & Accountability Briefing Paper, 2025

This briefing paper responds to the expansion of private finance in global health, demystifying t... more This briefing paper responds to the expansion of private finance in global health, demystifying the process of financialisation and offering a vital counter-perspective to an increasingly pervasive but questionable narrative that positions private finance as necessary to the future of global health. The paper charts the expansion of private finance across global health, pointing to how actors once marginal to this sector are becoming central to its financing and governance. Drawing on several case studies and a growing body of evidence, the briefing paper highlights three overlapping concerns associated with the financialisation of global health: the high cost of private investment; the undermining of public health principles and values; and the weakening of democratic governance and regulatory capture by powerful private financial actors.

Research paper thumbnail of Public health systems in the age of financialization: lessons from France and Brazil

Doctoral Thesis, Sorbonne Paris Nord University, 2022

Contemporary capitalism is underpinned by the process of financialization - the expansion of the ... more Contemporary capitalism is underpinned by the process of financialization - the expansion of the financial sector in size, scale, and power. Although this process is a key driver of transformations in the global economy, the mechanisms through which it reshapes Public Health Systems (PHS) remain poorly investigated. This thesis contributes to a better understanding of transformations in PHS by reassessing their trajectory from the fresh analytical framework of financialization. Incorporating this concept sheds light on actors, instruments, processes, and interests that have been critical in shaping reforms but which remain partially misapprehended.We hypothesize that PHS are being reshaped by the process of financialization in ways that are functional for the expansion of the financial sector and the accumulation of financial capital. To investigate this hypothesis, we combine a theoretical discussion with an empirical investigation of two universal health systems, in France and Brazil. Following a mixed-method approach that combines qualitative and quantitative information, we demonstrate the implementation of financialized policies in each PHS since the 1990s. This means policies leading them to adopt financial logics, engage with financial instruments, and participate in financial accumulation strategies.The first chapter introduces the topic of financialization and the inroads of finance into social provision. The second chapter conceptualizes PHS and suggests how to incorporate the notion of financialization into the analysis. The third and fourth chapters present the empirical findings. The conclusion systematizes these findings and elaborates a critical discussion on the problems associated with the adoption of financialized policies. We show that these policies transform PHS into vehicles for financial accumulation, decrease the stability of funding, and pose serious problems to democratic participation

Research paper thumbnail of Public health systems in the age of financialization: lessons from the French case

Review of Social Economy, 2021

Public Health Systems (PHS) are under continuous transformation in line with economic, political,... more Public Health Systems (PHS) are under continuous transformation in line with economic, political, and ideological changes in capitalist economies. The current stage of capitalism is underpinned by the process of financialization, meaning an increasing dominance of financial actors, markets, practices, measurements, and narratives over other agents, including the State. This article examines how financialization has been reshaping PHS, with an in-depth study of the French case. First, we suggest how to incorporate the concept of financialization into the research on PHS transformation. We then apply this concept to reassess the trajectory of the French system from the 1990s onwards. We show the increasing participation of financial capital for long-term, short-term, and infrastructure financing, occupying roles previously fulfilled by the public sector. We then discuss how the adoption of financialized strategies led to shifts in how public actors behave, and the potentially adverse effects for solidarity, stability, and democratic participation.

Research paper thumbnail of Protecting People Or Finance? On the Need To Free Social Policies From Financial Markets During And After Crises

EPOG Policy Briefs, 2020

Through the French case, this policy brief uncovers the promises and perils of making social poli... more Through the French case, this policy brief uncovers the promises and perils of making social policies dependent on financial markets, especially during crises. It discusses alternatives that are better suited for fostering social wellbeing and economic stability in the long run.

Research paper thumbnail of How Financialization Reshapes Public Health Care Systems : The Case of Assurance Maladie

CEPN Working Papers 03-2020, 2020

This article seeks to show how financialization is reshaping Public Health Care Systems (PHCS). T... more This article seeks to show how financialization is reshaping Public Health Care Systems (PHCS). To do so, we combine a theoretical discussion and an empirical investigation to examine the increasing participation of financial actors and instruments in these systems over the last decades. In the first part, we present the conventional approach for assessing PHCS transformation to date and argue for the need to incorporate the concept of ’financialization’. In the second part, we suggest a method for empirically examining how financialization alters the internal structures and organization of PHCS. In the last part, we apply this method to conduct an in-depth analysis of the French public health system, Assurance Maladie (AM). Our findings provide robust evidence that financialization had a major influence in the direction taken by the post-1990s reforms in this case, with new strategies allowing the increased participation of financial capital in the system’s long-term, short-term, and investment financing. In the conclusion, we provide a critical assessment of financialized strategies, highlighting their adverse impacts on core principles of PHCS such as solidarity, stability, and democratic participation.

Research paper thumbnail of The reshaping of healthcare systems in the age of financialization. Lessons from France and Brazil. / Transformações dos sistemas de saúde na era da financeirização. Lições da França e do Brasil

Revista Ciência e Saúde Coletiva, 2018

(English version) Since the post-War period, social protection systems have experienced continuou... more (English version)
Since the post-War period, social protection systems have experienced continuous reforms , either extending or, more often, reducing the scope and the scale of public provision. This paper seeks to present how healthcare systems have evolved both in France and in Brazil recently , in order to comprehend mechanisms through which financialization has been reshaping public care provision. This comparative analysis unveils distinct financialization dynamics of healthcare systems, built upon universalism principles. After featuring both systems, underlying their private dimension – either complementary or supplementary – the article points out how the financial sector is broadening its share in the supply of healthcare services. In what follows, the sector's process of internationalization/centralization is analyzed and lastly the regulatory role of the State in strengthening private provision is defined. Despite radically different institutional paths, the findings corroborate that in both cases finance is a driving force in reshaping the healthcare sector.

(Portuguese version)
Desde a segunda metade do século XX, reformas tornaram-se contínuas no âmbito dos sistemas de proteção social, ampliando ou, com mais frequência, restringindo o escopo e a escala da provisão pública. Neste artigo, cotejamos a evo-lução recente dos sistemas de saúde na França e no Brasil, de modo a apreender os mecanismos atra-vés dos quais a " financeirização " vem reforma-tando a provisão pública. Essa abordagem com-parada tem por finalidade explicitar dinâmicas diferenciadas de penetração do capital financeiro em sistemas de saúde que se pautaram por princí-pios universalistas. Após caracterizar brevemente ambos os sistemas de saúde, destacando o alcance da provisão privada seja complementar, seja su-plementar, o artigo mostra como o setor financeiro vem ampliando sua participação na oferta de ser-viços de saúde. Em seguida, analisa como se dá o processo de internacionalização/centralização do setor, e, finalmente, sintetiza o papel regulatório do Estado no fortalecimento da provisão privada. Os resultados indicam que, a despeito de trajetó-rias institucionais radicalmente opostas, a marcha da financeirização avança no setor de saúde.

Research paper thumbnail of Desoneração da folha de pagamentos: impactos na competitividade e política social

Master thesis at Federal University of Rio de Janeiro (text in Portuguese). Advisor: Prof. Lena L... more Master thesis at Federal University of Rio de Janeiro (text in Portuguese).
Advisor: Prof. Lena Lavinas

Desde os anos 90, as desonerações tributárias vêm se consolidando como um dos principais instrumentos do governo brasileiro para estimular a indústria nacional, que tem na desoneração da folha de pagamentos adotada no início do mandato de Dilma Rousseff em 2011 um de seus maiores exemplos recentes. Ao mesmo tempo em que tais medidas não se provam capazes de contrarrestar a visível perda de dinamismo do setor, implicam em uma renúncia crescente a receitas vinculadas ao financiamento da proteção social no país. Este trabalho se propõe a analisar os impactos da desoneração da folha sobre a competitividade e a política social brasileira, com base na trajetória das renúncias tributárias, exportações, importações e emprego em dois dos primeiros segmentos beneficiados pela medida, vestuário e couro/calçados. Os resultados corroboram a hipótese de que tal política, assim como as desonerações tributárias em geral aplicadas no Brasil, possuem uma natureza essencialmente “espúria” – isto é, incapazes de garantir ganhos econômicos sustentáveis e compatíveis com efetivo progresso social no longo prazo.

Research paper thumbnail of Asymétries de Genre sur le marché du travail au Brésil: les enjeux de la formalisation

Asymétries de Genre sur le marché du travail au Brésil: les enjeux de la formalisation

In: Nadya Araujo Guimaraes; Margaret Maruani; Bila Sorj (Org.). Genre, race, classe - Travailler ... more In: Nadya Araujo Guimaraes; Margaret Maruani; Bila Sorj (Org.). Genre, race, classe - Travailler en France et au Brésil. 1ed. Paris: Hartmann, 2016, v.1 p.111-133

Research paper thumbnail of Assimetrias de gênero no mercado de trabalho no Brasil: rumos da formalização.

Assimetrias de gênero no mercado de trabalho no Brasil: rumos da formalização.

In: Alice Rangel de Paiva Abreu, Helena Hirata e Maria Rosa Lombardi (Org.). Gênero e trabalho no... more In: Alice Rangel de Paiva Abreu, Helena Hirata e Maria Rosa Lombardi (Org.). Gênero e trabalho no Brasil e na França. Perspectivas interseccionais. 1 ed. São Paulo: Boitempo, 2016.

Research paper thumbnail of Income distribution and economic growth: unfolding different approaches on the Brazilian case

Master thesis at Université Paris 13. Advisor: Prof. Marc Lavoie Co-advisor: Prof. Gary Dimsky ... more Master thesis at Université Paris 13.
Advisor: Prof. Marc Lavoie
Co-advisor: Prof. Gary Dimsky

Abstract: This study systematizes relations between income distribution and economic growth on the Structuralist and Post-Keynesian schools of thought, using such contributions to discuss the evolution of the Brazilian economy in the last fifteen years, when redistribution policies gained a huge momentum as drivers of a new growth strategy. Based on the assumption of its “rise and fall” from 2000 to 2015, the main goal is to discuss possible explanations for such an evolution according to different frameworks of economic theory. Considering the observation of a change on income distribution in this period, this is done by comparing predicted outcomes of such process over economic growth with empirical results, using each particular framework to infer causal relations and explain eventual inconsistencies between theory and reality.
The first chapter presents different interpretations on how income redistribution affects economic growth (and other crucial elements of capitalist economies) according to two heterodox schools of thought, Structuralism and the post-keynesian theory of “growth regimes”.
The choice of these specific branches is justified not only by the centrality assumed by this relation in their theoretical frameworks as well as by the fact that they are two of the main references for
the discussion of the Brazilian case in recent times. The second chapter provides an empirical basis to discuss such interpretations, presenting the evolution of different economic and social indicators from 2000 to 2015. Finally, the last chapter uses the selected economic theories as a
background to discuss the outcomes observed during the period of an alleged shift on economic distribution. By recovering predicted causal relations and comparing it to what seems to have occurred in practice, it allows to identify potentially important obstacles for the establishment of a sustainable path of economic development based on a more fair redistribution of income in Brazil, as expected in the beginning of this period.

Research paper thumbnail of Desoneração da Folha de Pagamentos para Competitividade Espúria?

A Desoneração da Folha de Pagamentos adotada pelo governo Dilma vem sendo exaltada por grande par... more A Desoneração da Folha de Pagamentos adotada pelo governo Dilma vem sendo exaltada por grande parte dos setores público e privado como uma medida necessária e eficaz para promover a competitividade da indústria nacional, sofrendo contínua expansão desde o inicio de sua implementação em 2011: de 4 setores econômicos inicialmente beneficiados para mais de 50 em 2014. 1 Adotada sob caráter temporário, declarações do Ministério da Fazenda afirmam que a partir de 2015 a regra deve tornar-se permanente e ainda mais ampla, implicando uma renúncia de recursos que somente para este ano foi estimada em R$ 21,6 bilhões. 2 No entanto, seu caráter não é inovador: a concessão de benefícios tributários ao setor privado têm sido uma constante dentre as principais políticas de incentivo do governo brasileiro desde os anos 90, ganhando ainda mais destaque com sua ampla utilização para combate aos efeitos recessivos da crise internacional após 2008, e apoiando-se cada vez mais na renúncia a recursos destinados à Política Social. Este artigo procura relativizar as perspectivas de efetividade da política de desoneração da folha de pagamentos, dimensionando-a dentro da extensa trajetória de concessão de benefícios tributários como instrumento de estímulo econômico do governo brasileiro. Busca-se refletir sobre a natureza potencialmente espúria dos ganhos de competitividade associados a tais instrumentos – isto é, incapazes de garantir uma inserção internacional sustentável e com maior inclusão social. O argumento sustenta-se na ideia de que, embora os incentivos tributários tenham crescido desde o final do século XX, a persistência dos problemas de competitividade interna e externa enfrentados pela indústria brasileira (sinalizada pelo baixo crescimento da indústria de transformação, especialmente em setores expostos à concorrência internacional, e pela deterioração da Balança Comercial com crescente dependência dos produtos primários) parece indicar sua incapacidade em contrabalançar diversas forças contrárias à elevação da competitividade nacional, garantindo os resultados esperados. A primeira dimensão do caráter potencialmente espúrio dos ganhos decorrentes das desonerações tributárias, como a da folha de pagamentos, se daria pela manutenção de obstáculos sistêmicos que há décadas prejudicam a competitividade brasileira, conferindo-lhes assim efetividade duvidosa no longo prazo. A segunda dimensão, o conflito com o progresso social, fundamentar-se-ia pela concessão de benefícios ao setor privado apoiados em recursos próprios da Seguridade Social, instituição central para garantia de acesso a direitos universais básicos e redução da pobreza e desigualdade no Brasil.

Research paper thumbnail of Limites ao processo de redução das desigualdades sociais na América Latina

Paper published in Revista Brasileira de Estudos Latino-Americanos (text in Portuguese). Resumo ... more Paper published in Revista Brasileira de Estudos Latino-Americanos (text in Portuguese).

Resumo
A proposta deste artigo é analisar a estratégia de redução das desigualdades sociais característica de governos latino-americanos a partir da década de 2000 e suas possíveis limitações no que se refere à promoção efetiva de maior equidade social no longo prazo. Tais barreiras dar-se-iam principalmente devido (i) à expansão de um modelo neoliberal de Política Social, calcado na crescente focalização e mercantilização de bens e serviços essenciais; (ii) aos avanços no mercado de trabalho como fator de liderança do processo recente de inserção social, caminho vulnerável aos ciclos econômicos e restrito a uma parcela da população, em detrimento ao fortalecimento de sistemas institucionalizados de Proteção Social; e (iii) pela elevada fragilidade e/ou regressividade dos sistemas tributários da região.
Palavras-chave: América Latina, desenvolvimento econômico, desigualdade social, equidade.

Limits for the reduction of social inequalities in Latin America

Abstract
This paper analyzes strategies for reducing social inequalities by latin american governments since the 2000’s decade, as well as its possible limitations for promoting social equity in the long run. The argument is that such obstacles could emerge mainly due to (i) the expansion of a neoliberal model of Social Policy, increasingly based on targeting and commodification of essential goods and services; (ii) the leading role of labor market changes in the recent process of social inclusion at the expense of strengthening Social Protection Systems; (iii) highly fragile and/or regressive tax systems.
Key-words: Latin America, economic development, social inequality, social equity

Research paper thumbnail of É possível enfrentar o deficit fiscal combatendo a desigualdade? Recuperando o papel da política tributária

Book chapter. In: Luiz Gonzaga de Mello Belluzzo e Paulo Zahluth Bastos (Org.). Austeridade para ... more Book chapter. In: Luiz Gonzaga de Mello Belluzzo e Paulo Zahluth Bastos (Org.). Austeridade para quem? balanço e perspectivas do governo Dilma Rousseff. 1ed. São Paulo: Carta Maior/Friedrich Ebert, 2015,