Os vários mundos do financiamento da Saúde no Brasil: uma tentativa de integração

Abstract

Abstract

Federal funding of health policy in Brazil: trends and challenges

“…Conflicts persisted over application of the CPMF tax even after approval of Constitutional Amendment 29 in 2000 [which obligated minimum spending on health at the Federal, State, and Municipal levels] 8 . In reality, in terms of the Federal government's funding obligation, tied to variation in the GDP, the amendment's formula apparently failed to favor an increase in Federal funds at that time 6,7 , perhaps because the amendment's main objective was to expand State expenditures. This study corroborated previous research on the first decade of the 21 st According to estimates by the Institute of Applied Economic Research (IPEA) 24 , during most of the period analyzed here, Federal spending on health showed a cyclical pattern, fluctuating according to the acceleration or deceleration of the economy, as measured by GDP.…”

“…Numerous studies have explored the limits and impasses of health financing in the context of implementing the SUS in the 1990s, related to restrictions on the financing of social policies, fluctuations in funding sources, weak investment policy, instability in the provision of funds from the Brazillian Ministry of Health, and financial disparities between States and municipalities, among other factors 6,7,8,9,10 .…”

Austeridade, predominância privada e falha de governo na saúde

“…The unchanging relative percentages of government and private expenditure in the 1990s and 2000s is due essentially to funds being input by the municipal governments 29 . The participation of specifically municipal expenditure on healthcare underwent a significant expansion within government expenses as a whole: in 1995 the municipal percentage was 12.3%; and in 2012, it had risen to 18% of total public expenditures -while the expenditures of the state governments remained stable at around 25% of total Brazilian public expenditures on health.…”

A internacionalização da saúde: elementos contextuais e marcos institucionais da cooperação brasileira

“…Para alguns, sob uma perspectiva mais crítica, a reforma sanitária brasileira teria se afastado de seu sentido político original, mais amplo e radical no que concerne ao modo de organização da sociedade brasileira e de suas formas coletivas de viver e adoecer (1). Para outros, por exemplo, ainda que em sua dimensão setorial restrita, a reforma sanitária, desde muito cedo, tem enfrentado obstáculos políticos e estruturais consideráveis -e ainda não transpostos (2,3).…”