Panorama do financiamento da saúde no Estado do Amazonas

Abstract

The Unified Health System, better known by the acronym SUS, is one of the most important social achievements that resulted from the struggle of the Brazilian people against the military dictatorship that ruled the country between 1964 and 1985. Since then, the health reform triggered in Brazil, pursues the expansion of coverage and improving the quality of individual and collective attention of the population, aiming to ensure the universal access, the equity in care, the full assistance and the principles established by the Magna Letter adopted in 1988 and subsequently regulated by the Organic Laws of Health (Law 8080 and Law 8142 of 1990). In this set of rules are detailed procedures necessary for the decentralization of the health system with a single command on each level of government and the mechanisms that ensure social control, but failed to define the unique, sufficient and permanent sources of funds to finance the health actions. So, despite being set up as a single, SUS partially exists as a fragmented system that legally provides a public service of health, but needs regulation to prevent the hypertrophy of private service that should be only complementary. The consequence is that, after almost thirty years since the implementation of SUS, the underfunding is still seen as the main gap for its consolidation next to the mismanagement and corruption that make scarce resources for health. This study analyzes the topic of financing and management of SUS in the State of Amazonas context, which calls attention to the singularity of the situation in which, over the years, spending on health have always been above the national average in both percentage of own resources invested as in per-capita values. Another aspect concerns the management mode which produced such diversity of relationship between public and private, for the benefit of this second that probably immerses us in the most creative health commodification laboratory throughout Brazil, since the implementation of SUS.