To cover the overall financing needs of the Unified Health System (SUS), public spending on health must reach values equal to at least 6% of GDP by 2030. The analysis is from the Institute for Health and Health Policy Studies (IEPS), in the MIS Agenda document SUS, issued on Monday, 4, with the aim of providing subsidies to the policies of the presidential candidates.
In the past 10 years, total health spending in Brazil has increased, reaching 9.51% of GDP in 2018. However, the government spent only 3.96% of this total – and it has remained constant over the years. The rest is equivalent to private spending by Brazilian families. This means, according to the IEPS analysis, that the SUS will be underfunded if public spending on health does not increase significantly in the coming years, with “deteriorating health outcomes and increasing inequality in the country”. The rapid aging of the Brazilian population is of particular concern.
“Our population is aging three times faster than in the UK and France, and our fertility is already low,” said demographer Marcia Castro, director of global health and population at Harvard School of Public Health, who took part in the online launch. “Besides this demographic scenario, we also have an increase in obesity, a return of hunger, persistence of infectious diseases, the emergence of new diseases, a decrease in vaccination coverage, and an increase in extreme weather events.”
Currently, the percentage of Brazilian government spending on the health of the population is among the lowest in the world, according to analysts. According to figures from the latest Health Satellite Account Survey, conducted by the Brazilian Institute of Geography and Statistics (IBGE), released in April of this year, this percentage is only higher than that of Mexico, whose administration invests only 2.7% of its GDP in health. . This indicates a health care system that is “chronically underfunded”.
“We need more and better spending on public health, due to the progressive nature and the high social return generated by policies such as the Family Health Strategy, as well as the increasing demands associated with an aging population and differences in medical and hospital costs,” supports the analysis of the IEPS, a non-governmental organization formed by Names such as Paulo Hartung, Armenio Fraga and Marcia Castro.
“Strengthening the health system is essential in combating an emergency like that of COVID-19,” said IEPS Director of Public Policy, Arthur Aguilar.
Brazil is a signatory to an agreement signed with the Pan American Health Organization (PAHO), according to which all countries in the region must achieve a public investment in health equivalent to 6% of GDP by 2027. According to the agreement, the increase should be approximately 1% every four years – the electoral cycle. Therefore, the next government must increase public spending on health from the current 3.96% to approximately 5% by 2026.
According to the Mais SUS Agenda, the increase in public spending on health can be implemented through four strategies: “the explicit elimination or reduction of tax credits on health, the reallocation of existing resources to other areas, and the promotion of increased spending on health by other entities. Federal Charter Entities and other sectors and tax increases on economic sectors that incur a significant cost to the health of the population, such as sugary drinks, ultra-processed foods, alcohol and tobacco.”
“An investment in health is not an expense, it is an investment in the future of the country,” Marcia Castro remembers. “SUS is one of the biggest mechanisms for reducing inequality in Brazil.”
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