Acessibilidade / Reportar erro

Funding health: unsolved impasses

The article seeks to dialogue with the discoveries presented by Luciana Dias de Lima in her article about fiscal federalism and decentralized funding of health in Brazil by presenting partial, unpublished results of a study carried out between 2006 and 2008 regarding basic care funding strategies in cities with more than 100,000 inhabitants in the State of São Paulo. The study involved two interrelated modules: secondary data collection and analysis, seeking to relate health funding indices on the local plan to basic care performance levels, and semi-structured interviews with health managers of selected cities. The results show, on one token, that the different basic care models that exist in the cities, as well as the differentiated levels of efficacy and effectiveness of the municipal health systems, are related to the health funding and expenditure standard in these cities; and, on the other, that there are several aspects that tend to play decisive roles in the availability of financial resources for the development of basic care, including committing resources with medium-complexity and high-complexity services and the city's political alignment with the remaining spheres of government.

Single Health System; fiscal federalism; funding; basic care


Fundação Oswaldo Cruz, Escola Politécnica de Saúde Joaquim Venâncio Avenida Brasil, 4.365, 21040-360 Rio de Janeiro, RJ Brasil, Tel.: (55 21) 3865-9850/9853, Fax: (55 21) 2560-8279 - Rio de Janeiro - RJ - Brazil
E-mail: revtes@fiocruz.br