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Financing Needs, Spending Projection and the Future of Health in Brazil


  • Rudi Rocha
  • Isabela Furtado
  • Paula Spinola


In this paper we adopt a growth accounting projection model to estimate and characterize health‐financing needs in Brazil as well as to assess the extent to which financing needs may diverge from spending capacity in the future. We estimate an annual increase of 0.71% in the share of projected financing needs relative to GDP, with excess growth rates being 0.74% and 0.69% for the public and private health sectors, respectively. Institutional reforms and public spending restrictions may leverage public–private segmentation in health financing throughout the next decades, thus potentially leading to losses of equity in the system. Our projections contribute to a scant empirical literature on health financing sustainability in low‐ and middle‐income countries and shed light on the role of spending capacity and institutional constraints over the path towards universal health coverage.
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  • Rudi Rocha & Isabela Furtado & Paula Spinola, 2020. "Financing Needs, Spending Projection and the Future of Health in Brazil," Working Papers 06, Instituto de Estudos para Políticas de Saúde.
  • Handle: RePEc:amc:wpaper:06

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    References listed on IDEAS

    1. Daron Acemoglu & Amy Finkelstein & Matthew J. Notowidigdo, 2013. "Income and Health Spending: Evidence from Oil Price Shocks," The Review of Economics and Statistics, MIT Press, vol. 95(4), pages 1079-1095, October.
    2. Amanda Glassman and Juan Ignacio Zoloa, 2014. "How Much Will Health Coverage Cost? Future Health Spending Scenarios in Brazil, Chile, and Mexico - Working Paper 382," Working Papers 382, Center for Global Development.
    3. Badi H. Baltagi & Raffaele Lagravinese & Francesco Moscone & Elisa Tosetti, 2017. "Health Care Expenditure and Income: A Global Perspective," Health Economics, John Wiley & Sons, Ltd., vol. 26(7), pages 863-874, July.
    4. Felder, Stefan & Meier, Markus & Schmitt, Horst, 2000. "Health care expenditure in the last months of life," Journal of Health Economics, Elsevier, vol. 19(5), pages 679-695, September.
    5. Christine de la Maisonneuve & Rodrigo Moreno‐Serra & Fabrice Murtin & Joaquim Oliveira Martins, 2017. "The Role of Policy and Institutions on Health Spending," Health Economics, John Wiley & Sons, Ltd., vol. 26(7), pages 834-843, July.
    6. Robert E. Hall & Charles I. Jones, 2007. "The Value of Life and the Rise in Health Spending," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 39-72.
    7. Chernew, Michael E. & Newhouse, Joseph P., 2011. "Health Care Spending Growth," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 1-43, Elsevier.
    8. Mihajlo Jakovljevic & Elena Potapchik & Larisa Popovich & Debasis Barik & Thomas E. Getzen, 2017. "Evolving Health Expenditure Landscape of the BRICS Nations and Projections to 2025," Health Economics, John Wiley & Sons, Ltd., vol. 26(7), pages 844-852, July.
    9. Felder, Stefan & Werblow, Andreas & Zweifel, Peter, 2010. "Do red herrings swim in circles? Controlling for the endogeneity of time to death," Journal of Health Economics, Elsevier, vol. 29(2), pages 205-212, March.
    10. Bhalotra, Sonia R. & Rocha, Rudi & Soares, Rodrigo R., 2019. "Does Universalization of Health Work? Evidence from Health Systems Restructuring and Expansion in Brazil," IZA Discussion Papers 12111, Institute of Labor Economics (IZA).
    11. Steinmann Lukas & Telser Harry & Zweifel Peter S., 2007. "Aging and Future Healthcare Expenditure: A Consistent Approach," Forum for Health Economics & Policy, De Gruyter, vol. 10(2), pages 1-28, March.
    12. Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), 2011. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, volume 2, number 2.
    13. Beatriz Rache & Rudi Rocha & Letícia Nunes & Paula Spinola & Ana Maria Malik & Adriano Massuda, 2020. "Necessidades de Infraestrutura do SUS em Preparo à COVID-19: Leitos de UTI, Respiradores e Ocupação Hospitalar," Technical Notes 003, Instituto de Estudos para Políticas de Saúde.
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    Cited by:

    1. Natalia Nunes Ferreira‐Batista & Adriano Dutra Teixeira & Maria Dolores Montoya Diaz & Fernando Antonio Slaibe Postali & Rodrigo Moreno‐Serra & James Love‐Koh, 2023. "Is primary health care worth it in the long run? Evidence from Brazil," Health Economics, John Wiley & Sons, Ltd., vol. 32(7), pages 1504-1524, July.
    2. Szklo, Michel & Clarke, Damian & Rocha, Rudi, 2024. "Does Increasing Public Spending in Health Improve Health? Lessons from a Constitutional Reform in Brazil," IZA Discussion Papers 16829, Institute of Labor Economics (IZA).

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