Financiamento das politicas de saude no Brasil

Abstract

The purpose of this article is to examine the structure of health financing and expenditure in Brazil, based on the different components and institutions that manage the sector. The main public sources of financial and tax resources for the sector are described and special reference is made to the national fiscal budget, the Social Security and Welfare Fund (FPAS), the Social Invesment Fund (FINSOCIAL), and other federal social funds and state and municipal budgets. Expenditure is analyzed both from the vantage point of the institutions involved in managing the resources- Ministry of Health, National Medical Care and Social Security Institute (INAMPS), state and municipal secretariats- and from the standpoint of existing health programs and subprograms (medical care, public health, etc). Public expenditure is also compared to private expenditure, in order to estimate total health disbursements in Brazil and their functional breakdown. The repercussions of the economic crisis of the eighties were responsible for significant cutbacks i resources. In this regard, the author analyzes the main adjustment strategies used, especially by the Ministry of Social Security, to deal with the reduction in available resources. Lastly, the article identifies the main problems of the present system of sectoral financing and discusses changes in the system which have been proposed by the VIII National Health