Sístoles e diástoles no financiamento da saúde em Minas Gerais:período pós-Constituição de 1989

Abstract

The goal of this paper is the public health financing study in the State of Minas Gerais, within the period comprised between the promulgation of Minas Gerais Constitution, on September 21, 1989 and the year of 2005. The text also analyses the public health financing in the federalism, in Minas Gerais, on different moments of constitutional biding: during the term of the constitutional system established by the state Constitution § 1º of art. 158 of 1989, and during the term os the Republic Constitution Amendment nr. 29, of September 13, 2000. The present paper builds the historical series from 1989 to 2005, with the amounts of the expense with health by the State of Minas Gerais, as from the General Balance Sheets of the State. Through these data it is proved that the investment of resources in actions and public health services has not been increased with the enforcement of the EC-29, on the contrary, we verify a reduction to the financial support accomplished in 2005 when compared to the amount invested in 1995 (15,62%). The historical series building on municipalities of Minas Gerais within the period 1996-2005, shows in Minas Gerais, in the period analyzed, that the financial support of the local government and, the yearly average expressed in quadrienium 1996-1999 that antecedes the EC-29 enforcement. This pioneer study, since the Siops makes available the municipal data until the first semester of 2003, recommends the necessity of checking other states, as in Minas Gerais the EC-29 has proved to be a tool incapable of ensuring greater financial supports to the financing of actions and health public services. We also verified that, in the past four years, there is coherence among the four laws that compose the budget planning framework (PMDI, PPAG, LDOs, LOAs) and the respective General Balance Sheets of the State, but the Health State Fund (Fundo Estadual de Saúde FES) is not the budgeting unit that accomplishes the greatest part of the expenses in the health function . Finaççy, due to the results of the analyzed data, we decided for the need of an urgent proceduring of the complementary law project the regulates the EC-29. The external control of the public expenses and the implementation of the National Account in Health, are important strategies to make the private and public expenses with health more effective and efficient, since such financial supports are practically in the Brazilian reality.