Brazil’s public health has lowest federal spending forecast since 2012

RIO DE JANEIRO, BRAZIL – At a time when the public health system is still recovering from the peak in demand caused by the Covid-19 pandemic, the federal spending forecast in this area in the 2022 budget proposal is at the lowest level since 2012, according to a technical note from the Institute for Health Policy Studies (IEPS).

IEPS director of public policies Arthur Aguillar explains that despite lower demand for care in the SUS for Covid-19, as a result of vaccination, there is a repressed demand for several procedures, which fell 19% in 2020.

These patients’ conditions may have worsened, particularly in the case of people with chronic diseases. According to IEPS, addressing this situation in a low-resource scenario could be dramatic.

According to the institute’s survey, resources for Health total R$140.358 (US$25) billion in 2022. In recent years, the amounts have ranged between R$143.7 billion and R$159.9 billion, in figures adjusted for inflation through September 2021.

In 2012, the projected spending stood at R$149.9 billion. “We have a range of strains on the health system, with a prevalence of chronic diseases,” Aguillar says, also one of the technical note’s authors. The lack of sufficient resources could lead to a precarious service and the deterioration of the population’s health, with repercussions on the mortality rate, he says.

BASIC CARE

One of the study’s most critical points is the stagnation of resources for basic care. In the last four budget proposals, this expense fluctuated around R$25 billion, updated for inflation, with no significant increase. In 2022, this item was allocated 17% of the Ministry of Health’s total resources.

“This increases the demand for medium and high complexity care at a later stage. This increases human suffering and also the fiscal issue,” the director says, noting that these services cost more for the public system. “The cost falls on society itself.”

Another point addressed by IEPS is the drop in investments, which currently depend more on Congressional rider amendments – which may vary from year to year. In the government’s budget proposal, investments fell 77% between 2013 and 2022, from R$9.2 billion to R$2.1 billion.

According to Aguillar, unlike spending on education, which relies on the aging population “playing in its favor” to reduce the pressure, health spending should have an even greater demand for the same reason. He says it is possible to improve the current quality of spending, but stresses that this is “not enough” to solve the problem. Manuel Faria, Victor Nobre, and Renato Tasca are also authors of the technical note.

In their public statements, members of the economic team have been saying that there will be no shortage of resources for Health, particularly for the purchase of more doses of the Covid-19 vaccine.