Artigo 7 A Vinculacao Constitucional De Recursos Para A Sa De

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A vinculação constitucional de recursos para a saúde: avanços, entraves e perspectivas
Constitutional binding of resources for the health sector: breakthoughs, barriers and perspectives

Ana Cecília de Sá Campello Faveret 1

1 Ministério da Saúde,
Sistema de Informações sobre Orçamentos Públicos em Saúde.
Rua Joaquim Nabuco 186/
301, Ipanema, 20080-030
Rio de Janeiro RJ. [e-mail] Abstract As in other public policies, financing is a powerful element which induces strategies and actions in the health sector. On one hand, the financial decentralization put forward by the Federal Constitution of 1988 allowed municipalities to effectively take charge of their financing role in the health policy. On the other hand, during the first half of nineties, there was great instability of the federal financing of health. The Constitutional Amendment n. 29/00, which binds fiscal resources to expenditures with public health services and actions, was the way out of this situation. Its effective implementation, however, depend upon the advances in the understanding of the terms of the Constitution by the actors in the public health sector. Nonetheless, it is already possible to estimate that the share of the states in the financing of public health will improve greatly, while the federal government share will decrease and the municipalities will, in average, maintain their current level of public spending in health. This may imply that subnational governments will have greater autonomy in the design and implementation of health policies.
Key words Health policy, Public health, Financing, Unified Health System

Resumo Como em outras políticas públicas, o financiamento é um poderoso elemento indutor de estratégias e ações de saúde. Se, por um lado, a descentralização financeira promovida pela Constituição Federal de 1988 possibilitou aos municípios a assumirem efetivamente parte do financiamento da política de saúde, por outro lado, na primeira metade da década