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Master's Dissertation
DOI
https://doi.org/10.11606/D.2.2019.tde-30072020-145728
Document
Author
Full name
Renata Constante Cestari
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2019
Supervisor
Committee
Conti, José Mauricio (President)
Aith, Fernando Mussa Abujamra
Lochagin, Gabriel Loretto
Pinto, Élida Graziane
Title in Portuguese
Aspectos jurídicos e federativos do subfinanciamento da Saúde
Keywords in Portuguese
Federalismo
Retrocesso
Saúde
Subfinanciamento
Abstract in Portuguese
A efetividade das ações e serviços públicos de saúde é diametralmente ligada ao financiamento destinado à área. Corolário lógico de tal acepção é o arcabouço constitucional orçamentário que, em 1988, veio em auxílio de tão importante direito fundamental, reforçando o federalismo cooperativo fiscal e, somando a ele, o direito sanitário. Buscou-se cumprir o objetivo constitucional do desenvolvimento regional e da solidariedade, entretanto, sem êxito. O escopo do presente estudo consiste na demonstração da redução, por parte da União, do gasto mínimo em saúde, a despeito do valor originariamente determinado pela Constituição Federal de 1988, à ordem de 30% do orçamento da seguridade social; violando, também, a obrigação de progressividade do custeio constitucionalmente determinado e pautado pelo Pacto Internacional dos Direitos Econômicos, Sociais e Culturais. Isto porquanto o governo federal traçou uma trajetória de edições normativas regressivas, inconstitucionalmente amparadas pelas Emendas Constitucionais n. 86, de 17 de marco de 2015 e n. 95, de 15 de dezembro de 2016. Tais Emendas reforçam a ideia de que o Estado brasileiro estaria, como de fato está, desobedecendo ao princípio da vedação ao retrocesso social. A metodologia utilizada para a demonstração do alegado se pauta na análise de processos judiciais e administrativos oriundos do Supremo Tribunal Federal, Tribunal de Contas da União e Conselho Nacional de Saúde, quanto ao retrocesso do financiamento público. O resultado dos estudos em questão desagua num cenário de crise, agravado por impasses normativos e gerenciais capazes de agravar o subfinanciamento da saúde a um patamar jamais constatado na história recente do país. Entretanto, e à luz de tudo o quanto foi apurado, soluções viáveis são sugeridas por doutrina abalizada que, apesar de ressentida diante do caos instaurado, crê que o pedido de socorro que ecoa da saúde pública alcance o Supremo Tribunal Federal para que este, julgue, em definitivo, as Ações Diretas de Inconstitucionalidade n. 5595 e 5658 a fim de restaurar, ainda que em passos largos, a saúde do Brasil.
Title in English
Legal and federative aspects of Health underfunding
Keywords in English
Federalism
Health
Retreat
Underfunding
Abstract in English
The effectiveness of public health actions and services is diametrically linked to funding for the area. Logical corollary of such a meaning is the constitutional budgetary framework that, in 1988, came to the aid of this important fundamental right, reinforcing fiscal cooperative federalism and, adding to it, the sanitary right. Sought to fulfill the constitutional objective of regional development and solidarity, however, without success.The present study scope is based on the reduction on the part of the Union demonstration, on minimum spending on health, despite the value originally given by the federal Constitution of 1988, as well as the order of 30% of the social security budget; violating, in addition, the requirement of progressiveness of the constitutionally determined on costing and guided by the Pact International economic, social and cultural rights. This is due to the federal Government outlined a history of regulatory issues, unconstitutionally afforded in regressive constitutional amendments n. 86, from 17 March 2015 and n. 95, from 15 December 2016. These amendments reinforce the idea that the Brazilian State would be, disobeying the principle of sealing the social backlash. The methodology used to demonstrate the alleged is based on analysis of judicial and administrative proceedings from Federal Supreme Court, Court of Auditors and National Health Council, about the Government funding. The result of these current studies flows in a scenario of crisis, compounded by regulatory and managerial dilemmas which are able to lift the underfunding of health to a larger level than that already established in the recent history of the country. However, and everything about it was found, viable solutions are suggested by authoritative doctrine that, despite bitter in the face of chaos installation, believes that the distress call that echoes public health reaches the Supreme Court for this one judging ultimately the Direct Actions of Unconstitutionality n. 5595 and 5658 in order to restore, even in strides, the health of Brazil.
 
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Release Date
2022-07-30
Publishing Date
2020-08-05
 
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