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

Abstract

This paper addresses the dilemma underlying Healthcare financing, caught between the long-term view proposed by the Social Security segment in 1988 and the short-term view imposed by a series of fiscal adjustments, hampering the expansion of healthcare resources in Brazil. Within the context of Constitutional Amendment No 29, the extension of the Provisional Financial Transactions Levy (CPMF), the Federal Funds Earmarking Removal Provision (DRU), and forthcoming tax reforms, aspects of the taxation system, social security dues, subsidies, incentives and tax revenue waivers are examined, also exploring political and institutional aspects of intergovernmental relationships and the links between the public and private sectors, in terms of Healthcare financing. This paper spotlights the headroom available for stepping up the financing levels of Brazil's National Health System (SUS), in order to bridge public health gaps and even out inequalities in nationwide service supplies. A review of intergovernmental relationships and the links between the public and private sectors is also suggested. Finally, positive aspects of Government spending are presented, together with financing tools for this sector that would spur the economic and technological development of Brazil.