Em busca de recursos para a saúde: a implantação da Emenda Constitucional nº 29

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Malik, Ana Maria
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Since the National Health System (SUS) was created by Brazilian 1988 Constitution, one of its goals has been the stability and sufficiency of its financing model. The financing crisis that took place as early as from the years 1990 generated new proposals related to SUS financing. These initiatives led to the approval of Constitutional Ammendment no 29 (EC 29), in september 2000, which established resource ear-marking for the three governmental levels. However, the implementation of this new financing model has been characterized by controversial interpretations of what EC 29 really said. Using the theory from Fiscal Federalism, this thesis aims to study the implementation of resource ear-marking for health, through documental annalysis regarding the National Health Council (CNS) and Audit Offices at the federal, state and municipal levels. Data bases from the National Treasure and Health Public Budget Information Systems (SIOPS), from the Ministry of Health were used to gather data regarding revenues and expenses from federate units. In conclusion, it can be said that EC 29 was an advancement in SUS financing. Nevertheless, some issues are not yet solved. How to treat inequities, how to redistribute resources among different federate units are still unresolved issues, without a strong association with performance goals and responsibility sharing. The forecast of periodical revisions of EC 29´s legal text offers an uncommon opportunity for improving the financing model.

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