0342/2021 - FINANCIAMENTO DA SAÚDE E DEPENDÊNCIA FISCAL DOS MUNICÍPIOS BRASILEIROS ENTRE 2004 E 2019 FINANCING OF HEALTH AND FISCAL DEPENDENCY OF BRAZILIAN MUNICIPALITIES BETWEEN 2004 AND 2019
Este artigo descreve a evolução do financiamento municipal do Sistema Único de Saúde, de 2004 a 2019, considerando receitas e despesas de fontes próprias e não-próprias, analisa a redistribuição fiscal, de acordo com o porte populacional e a renda média domiciliar, e compara essa evolução em dois períodos, caracterizados como de crescimento econômico (2004-2014) e de recessão (2015-2019). O estudo se baseou em dados do Sistema de Informações sobre Orçamentos Públicos em Saúde. Constatou-se crescimento real dos gastos municipais em saúde de 2004 a 2014 (156,3%), com queda entre 2014 e 2015, seguida de recuperação até 2019. Na recessão, detectou-se aumento global da dependência fiscal dos municípios, indicada pelo aumento de receitas não-próprias, mesmo com a diminuição da participação da União nas transferências. O crescimento das despesas próprias em saúde foi menor entre os municípios de menor renda domiciliar, enquanto para as despesas não-próprias foi maior nos municípios de menor porte populacional. Em suma, indica-se um processo de incremento dos gastos municipais em saúde, assim como o aumento da dependência fiscal para custeio da saúde, intensificado após a crise de 2015, que atingiu especialmente os municípios de pequeno porte e de menor renda domiciliar.
Palavras-chave:
Financiamento dos Sistemas de Saúde, Saúde Pública, Política Fiscal, Recessão Econômica, Brasil
Abstract:
This article describes the evolution of municipal financing of the Unified Health System,2004 to 2019, considering revenues and expensesown and non-own sources, analyzes fiscal redistribution, according to population size and average household income, and compares this evolution in two periods, characterized as economic growth (2004-2014) and recession (2015-2019). The study was based on datathe Information System on Public Health Budgets. There was real growth in municipal spending on health2004 to 2014 (156.3%), with fall between 2014 and 2015, followed by a recovery between 2015 and 2019. During the recession period, there was an overall increase in the fiscal dependence of municipalities, indicated by the increase in non-own revenues, even with the decrease in the Federal Government participation in transfers. The growth of own health expenses was lower among municipalities with lower household income, while for non-own expenses it was higher in municipalities with a smaller population size. In short, the results indicate a process of increasing municipal spending on health, as well as the increased fiscal dependence of municipalities to fund health, intensified after the 2015 crisis, which especially affected small-sized and lower income municipalities.
Keywords:
Health System Financing, Public Health, Fiscal Policy, Economic Recession, Brazil
FINANCING OF HEALTH AND FISCAL DEPENDENCY OF BRAZILIAN MUNICIPALITIES BETWEEN 2004 AND 2019
Resumo (abstract):
This article describes the evolution of municipal financing of the Unified Health System,2004 to 2019, considering revenues and expensesown and non-own sources, analyzes fiscal redistribution, according to population size and average household income, and compares this evolution in two periods, characterized as economic growth (2004-2014) and recession (2015-2019). The study was based on datathe Information System on Public Health Budgets. There was real growth in municipal spending on health2004 to 2014 (156.3%), with fall between 2014 and 2015, followed by a recovery between 2015 and 2019. During the recession period, there was an overall increase in the fiscal dependence of municipalities, indicated by the increase in non-own revenues, even with the decrease in the Federal Government participation in transfers. The growth of own health expenses was lower among municipalities with lower household income, while for non-own expenses it was higher in municipalities with a smaller population size. In short, the results indicate a process of increasing municipal spending on health, as well as the increased fiscal dependence of municipalities to fund health, intensified after the 2015 crisis, which especially affected small-sized and lower income municipalities.
Palavras-chave (keywords):
Health System Financing, Public Health, Fiscal Policy, Economic Recession, Brazil
Cruz, W. G. N., de Barros, R. D., de Souza, L. E. P. F.. FINANCIAMENTO DA SAÚDE E DEPENDÊNCIA FISCAL DOS MUNICÍPIOS BRASILEIROS ENTRE 2004 E 2019. Cien Saude Colet [periódico na internet] (2021/dez). [Citado em 23/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/financiamento-da-saude-e-dependencia-fiscal-dos-municipios-brasileiros-entre-2004-e-2019/18241?id=18241
