Federal funding of health policy in Brazil: trends and challenges

Abstract

The article analyzes Federal funding of health policy in Brazil in the 2000s, focusing on the Ministry of Health’s budget implementation. Federal spending on health was less unstable between 2000 and 2002 and has expanded since 2006. However, it fluctuated as a share of both the Gross Domestic Product and Gross National Revenue. Federal intergovernmental transfers increased, exceeding 70% in 2007. Meanwhile, the proportion of Federal investments remained low, varying from 3.4% to 6.3%. The highest absolute amount of spending was on specialized outpatient and hospital care. The decade showed a proportionally greater increase in spending on pharmaceutical care. The growing allocation of Federal funds to States in the North and Northeast, especially for primary care and epidemiological surveillance, failed to offset the sharp regional inequalities in per capita Federal spending. The main characteristics of health funding limit Federal health policy governance and pose several challenges for the Brazilian Unified National Health System.

Aplicação de recursos financeiros para aquisição de medicamentos para atenção básica em municípios brasileiros

“…The hypothesis that may be related to this difference is access to health services. A study 25 showsthat federal expenditure per inhabitant, in a specialized outpatient clinic, hospital care and pharmaceutical services were higher in the Southeast and South regions, followed by the Midwest, with lower expenditure in the Northeast and North, thus reflecting the uneven supply and use of health services in the country.…”

Internações por condições sensíveis à atenção primária, gastos com saúde e Estratégia Saúde da Família: uma análise de tendência

“…Per-capita healthcare spending and primary care as a percent of the total were calculated. A deflator was used to eliminate or minimize the influence of inflation on prices 15,16 . Values were adjusted using the IPCA (Ample Consumer Price Index) published by the IBGE.…”

Políticas de saúde no Brasil em tempos contraditórios: caminhos e tropeços na construção de um sistema universal

“…There have been efforts to allocate resources to needier regions, but the persistence of problems with the tax distribution system 40 , associated to the cyclical character and low economic and fiscal priority of federal spending 41 have nullified any greater redistributive impacts of sectorial transfers.…”