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Financiamento Público da Saúde: uma História à Procura de Rumo

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  • Sérgio F. Piola
  • Andrea Barreto de Paiva
  • Edvaldo Batista de Sá
  • Luciana Mendes Santos Servo
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    Abstract

    Este trabalho analisa como o país tem enfrentado o desafio de prover um financiamento público adequado para a garantia do direito à saúde prevista na Constituição Federal de 1988 (CF/1988). Discute questões relacionadas ao processo de financiamento compartilhado do Sistema Único de Saúde (SUS), à descentralização de recursos federais para estados, Distrito Federal e municípios e à regulamentação recente da Emenda Constitucional (EC) no 29/2000, que visa assegurar os recursos mínimos para o financiamento das ações e serviços públicos de saúde nas três instâncias de governo. Mostra que a aprovação da EC no 29 levou a um crescimento dos recursos aplicados em Ações e Serviços Públicos de Saúde (ASPS), passando de 2,89% do Produto Interno Bruto (PIB) em 2000 para 3,91% do PIB em 2011. Discute, também, a recente regulamentação da EC no 29 por meio da Lei Complementar (LC) no 141/2012. Afirma que sua aprovação foi importante para uma definição mais precisa do que se entende por ASPS, ainda que não tenha havido mudança na regra de vinculação dos recursos federais para a saúde. A definição de critérios mais equitativos de distribuição de recursos da União para estados e municípios ainda continua necessitando de discussões no campo técnico-político. This article provides an analysis of policies adopted to ensure adequate funding to public health care in Brazil as determined by the 1988 Federal Constitution. Issues related to the tripartite funding of the SUS, the decentralization of federal financial resources to subnational levels of government and the recent regulation of the Constitutional Amendment (CA) 29/2000 are discussed. The CA 29/2000 led to an increase in financial resources to fund health care provided by the SUS from 2.89% of the GDP in 2000 to 3.91% in 2011. The recent regulation, Law 141/2012, helped define more precisely what should and what should not be considered health care provided by the SUS. Unfortunately, no change has been proposed regarding the proportion of federal revenues that should be committed to public health care. The definition of equitable criteria for the distribution of federal financial resources to subnational levels of government is also a pending issue.

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    Bibliographic Info

    Paper provided by Instituto de Pesquisa Econômica Aplicada - IPEA in its series Discussion Papers with number 1846.

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    Length: 46 pages
    Date of creation: Jul 2013
    Date of revision:
    Handle: RePEc:ipe:ipetds:1846

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