MUCH BEYOND THE MINIMUM why do brazilian municipalities overallocate their own revenues to healthcare?

MUITO ALÉM DO MÍNIMO: por que os municípios brasileiros alocam suas próprias receitas para a saúde?

BEAUCOUP AU-DELÀ DU MINIMUM: pourquoi les municipalités brésiliennes surutilisent-elles leurs propres revenus pour la santé?

Abstract

This article identifies reasons for Brazilian municipalities overallocating their own revenues to healthcare which, since the promulgation of Constitutional Amendment 29/2000, have progressively expanded them until they far exceed the constitutional minimum. Linear regression models with mixed panel effects were used for the period of 2008-2017. The tested hypotheses are related to the effects of the population scale of the municipalities; the level of economic and social development of the region in which they operate; the degree of incorporation of technological resources of medium and high complexity; the effort spent on basic care; political guidance from municipal governments; and, finally, to allocation to other budgetary functions and sub-functions of interest to healthcare. The results point to two factors which better explain the dependent variable: the population scale in inverse relation, and the concentration of greater technologically complex services in a direct relation.

Keywords:
Fiscal federalism; Constitutional Amendment 29/2000; health expenditure; own revenues; municipalities