Doubles the share of the basic health care budget set by Congress

Doubles the share of the basic health care budget set by Congress

*** FILE *** BRASILIA, DF, 26.04.2022 – President Jair Bolsonaro (PL) speaks with Mayor, Arthur Lira (PP-AL). (Photo: Gabriella Bello/Fullhabers)

BRASILIA, DF (Fulhapress) – The share of the federal budget for basic health care set by parliamentarians during the Jair Bolsonaro (PL) government has doubled and is now almost a fifth of the total. Experts point out that this has led to inefficient health spending, a disregard for technical standards, and the creation of client bonds between mayors and members of Congress.

The proportion of classified spending on primary health care in 2019, coming from parliamentary amendments, was 9.4% in 2019. In 2022, it was 18.1%.

The growth occurred in the wake of the explosion of the so-called scheduling amendments, of which health in 2022 was the main destination.

In this year’s budget, there were R$9.8 billion in parliamentary amendments of all kinds for basic healthcare, of which R$5 billion is with the decision stamp. In 2019, this type of mod did not exist.

There are four types of amendments: individual amendments (which each deputy and senator is entitled to), bench amendments (the members of Congress from each state determine district priorities), committee amendments (which are determined by members of collegiate bodies of Congress) and rapporteur (which are criticized for Lack of transparency because they control the House of Representatives and the Senate).

“This is one of the biggest distortions that the federal government together with the SUS (Unified Health System) funded center,” says Aparecida Pimenta, advisor to Cosems-SP (São Paulo Municipal Health Board of Trustees).

Prior to her current position, she was health minister in four cities within São Paulo.

“Often the Ministry of Health mentions how much primary care resources have been increased, but a large part of it has increased due to the adjustment — and [execução da] Modification has a beginning, middle and end. He pointed out that the biggest health problem is permanent funding, especially salaries.

Because of their temporary nature, adjustments cannot be used to hire doctors, nurses, or other health professionals. As a result, they end up buying supplies, renovating or building health facilities.

Primary health care, or primary care, is the gateway to SUS. The goal is to prevent disease, resolve certain conditions, and direct those who need more attention to intermediate or highly complex care. An important measure in primary care is, for example, a family health programme.

Federal MP and former Health Minister Alexandre Padilla (PT-SP) follows the same line. He says excessive adjustments lead to “the political interests of their base taking control” of the primary health care budget.

This “removes the technical criteria for allocating resources, turning primary care into a one-stop shop.”

Upon contact, the Ministry of Health did not comment on the increase in the share of parliamentary amendments in this type of spending.

Congressional technicians believe this process is detrimental to primary care policies, because the political standard does not necessarily meet the main demands of municipalities across the country.

Conasems (National Council of Municipal Health Trustees) welcomes resources arising from the amendments. “The problem is that the distribution of these resources follows the political logic laid down by parliamentarians, and it is not always the same as the logic of the public health care network.”

For the group, it is necessary to “enable the use of resources in accordance with the district health care network that is created according to the health needs of the population”.

Of the R$9.8 billion of adjustments for primary care in 2022, R$5 billion of scheduled adjustments and R$3.5 billion of individual adjustments.

In 2020, the first year with scheduled adjustments, there were R$862 million in this type of order and R$2.7 billion in individual adjustments.

In either case, the amendment is aimed at a municipality under the auspices of a designated Member of Parliament. The difference is that in decision amendments, the senator or representative who made the appointment is hidden.

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