A desproporcionalidade do gasto em saúde dos entes federativos brasileiros

Resumo

This article seeks to comparatively analyze the expenses of the Brazilian federative entities (Union, States and Municipalities) with health in relation to the proportion of their own tax and social contribution revenues earned by each of them in the general sum, in the period between 2002 and 2020. The objective is to demonstrate the existing disproportion in health financing between entities, considering the responsibility of each one in the provision of services and in the execution of public health policies. The theoretical framework used to support the analysis was the concept of federalism as a form of organization of the Brazilian State, which presupposes the decentralization of powers and the management of administrative, tax, political and financial matters among the federated entities. For this analysis, therefore, the concept of fiscal federalism was also detailed, which deals exactly with the division of powers and competences for tax collection, preparation of the public budget and provision of services. The data used in the analysis are from secondary origin, that is, from government sources that gather and consolidate these data in a primary way, and were collected through the quantitative method, through surveys in the sources' databases. After the collection, calculations were carried out to obtain the proportion of the participation of the federative entities both in their own revenues and in their own health expenditures, enabling the analysis and extraction of the results. The results point to a reduction in the Union's participation both in its own revenues and in health expenditures in the period and, in turn, an increase in the participation of municipalities in both variables. However, as a central conclusion, there is an improvement in the situation of the municipalities in the period - that is, the increase in collection was greater than the increase in health expenses - but the disproportion in relation to the Union (more than five times) and the states (more than four times) remains high.

Ficha do documento

Tipo

Relatório

Ano

2021

Instituição

Fundação Getulio Vargas

Fonte

Repositório da FGV

Idioma

Português

Acesso

Acesso aberto

Identificador

oai:repositorio.fgv.br:10438/31731

Temas

Políticas PúblicasFinanças PúblicasAdministração PúblicaSaúde

Palavras-chave

Política públicaPacto federativoFinanciamento da saúdeDesproporcionalidadeAdministração públicaPolíticas públicas - BrasilSaúde pública - FinanciamentoDisparidades regionais