The health sector is historically underfunded and the chronic budget deficit affects the capacity to provide quality services and achieve the goal of Universal Health Coverage. External financing, although an important component in the package of resources that the sector can count on, has not been sufficient to guarantee the strengthening of health systems and their consequent resilience and sustainability. In addition to these structural problems, considerable portions of financial resources are channelled through vertical mechanisms, outside of national planning and budgeting systems, limiting efforts of coordination and alignment. Therefore, in an attempt to increase the fiscal space for financing the sector, the Ministry of Health has produced a financing strategy in which several avenues are proposed to increase the package of resources. However, some observers dispute the quality of the document from the point of view of the feasibility of the proposals presented. Two of these proposals suggest increasing user fees and introducing health insurance, presenting a paradox between the need for increased resources and the ideology of access to health for all. On the other hand, the surcharge of products harmful to health, such as tobacco and alcohol, is already underway, yet it is unclear whether percentages of this tax will revert to the health sector.
This policy note problematizes these and other questions about the political economy of health sector financing. Leia mais...
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