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3.
Gac Sanit ; 34(1): 21-25, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-30482407

RESUMO

OBJECTIVE: In this paper we address whether the System for Personal Autonomy and Care of Dependent Persons contributes to increasing the volume of resources of the public social services system (displacement effect) or, on the contrary, whether this development has taken place at the expense of other social services (substitution effect). METHOD: Panel data analysis is used to explain how per capita expenditure on social services evolves in the Spanish Regions under the common regime in the period 2002-2016. RESULTS: The implementation of the Dependency Act is associated with a 14% increase in the level of per capita expenditure on social services. This effect raises 25% when the variable explained is expenditure on current transfers of a social nature. On the other hand, law changes introduced in 2012 and 2013 were associated with a reduction in per capita expenditure on current transfers of around 10%. CONCLUSIONS: This evidence would refute the hypothesis that the System for Personal Autonomy and Care of Dependent Persons had merely a "substitution" effect on autonomous spending on social services.


Assuntos
Orçamentos/legislação & jurisprudência , Gastos em Saúde/legislação & jurisprudência , Assistência de Longa Duração/economia , Seguridade Social/economia , Recursos em Saúde/economia , Recursos em Saúde/legislação & jurisprudência , Humanos , Assistência de Longa Duração/legislação & jurisprudência , Modelos Econométricos , Seguridade Social/legislação & jurisprudência , Fatores Socioeconômicos , Espanha
4.
Ciênc. Saúde Colet ; 24(12): 4473-4478, dez. 2019.
Artigo em Português | LILACS | ID: biblio-1055733

RESUMO

Resumo Ao longo das três décadas de vigência da Constituição Federal, redesenhos normativos e fiscais foram introduzidos pela União nas garantias de organização federativa solidária e de custeio dos direitos sociais, a pretexto de resguardar a sustentabilidade intertemporal da dívida pública brasileira. Para equalizar a tensão entre estabilidade econômica e efetividade dos direitos sociais e sua repercussão para o processo de endividamento, foram mitigados paulatinamente os pisos de custeio da saúde e educação e o orçamento da seguridade social, os quais operavam, tanto no campo simbólico, quanto no pragmático, como uma espécie de contrapeso fiscal à necessidade de custo alegadamente ilimitado para as políticas monetária e cambial. Desvincular receitas, reduzir o escopo dos regimes de gasto mínimo e restringir o alcance interpretativo de transferências intergovernamentais equalizadoras das distorções federativas tornou-se estratégia, assumida - direta ou indiretamente - pela União desde o início da década de 1990, de estabilização macroeconômica, sobretudo, monetária. Assim tem sido empreendido um longo e ainda atual processo de desconstrução orçamentário-financeira dos direitos sociais, que restringe a identidade estrutural da CF/1988, a pretexto de consolidação fiscal cada vez mais exigente da redução do tamanho do Estado.


Abstract Throughout the three decades of the Federal Constitution, normative and fiscal redesigns were introduced by the Union in the guarantees of solidary federative organization and of social rights costing, under the pretext of safeguarding the intertemporal sustainability of the Brazilian public debt. In order to equalize the tension between economic stability and the effectiveness of social rights and their repercussion for the indebtedness process, the health and education minimum spending and the social security budget were gradually mitigated, which operated both in the symbolic field and in the pragmatic, as a kind of fiscal balance to the need for allegedly unlimited cost for monetary and cambial policies. Unlink taxes, reduce the scope of minimum spending regimes and restrict the interpretative scope of intergovernmental equalization transfers of federative distortions has become a strategy, assumed - directly or indirectly - by the Union since the early 1990s, of macroeconomic stabilization policy, above all, monetary. Thus, a long and still ongoing process of budgetary and financial deconstruction of social rights has been undertaken, which restricts the structural identity of the FC/1988, under the pretext of increasingly demanding fiscal consolidation of the reduction of the size of the state.


Assuntos
Humanos , Orçamentos/legislação & jurisprudência , Governo Federal , Financiamento da Assistência à Saúde , Direitos Humanos/legislação & jurisprudência , Previdência Social/economia , Previdência Social/legislação & jurisprudência , Brasil , Educação/economia , Educação/legislação & jurisprudência , Direitos Humanos/economia
5.
Cien Saude Colet ; 24(12): 4405-4415, 2019 Dec.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31778491

RESUMO

This paper aims to identify new sources of revenue for the additional allocation of resources to meet the population's health needs fixed in the federal budget expenses, in the context of the Unified Health System (SUS) underfunding process and the negative effects of Constitutional Amendment 95/2016 for this process - verified decrease in the proportion of federal net current revenue destined to SUS. From this perspective, it is necessary to address the problem of underfunding by linking the search for additional resources with new sources of funding with actions and public health services that will be improved, expanded and created, of which criteria are: regarding sources, exclusivity for SUS, non regressive taxing and review of revenue waiver; and, regarding uses, prioritization of primary care as reference of the health care network and appreciation of civil servants in the health area. The result calculated for the sources ranged from R$ 92 billion to R$ 100 billion, higher than the R$ 30.5 billion calculated for uses under the described terms. A documentary research was conducted to collect data from secondary sources, especially in the reports sent to the National Health Council by the Ministry of Health.


Assuntos
Orçamentos/legislação & jurisprudência , Financiamento Governamental/legislação & jurisprudência , Financiamento da Assistência à Saúde , Programas Nacionais de Saúde/legislação & jurisprudência , Saúde Pública/legislação & jurisprudência , Alocação de Recursos/legislação & jurisprudência , Brasil , Financiamento Governamental/economia , Humanos , Programas Nacionais de Saúde/economia , Saúde Pública/economia , Alocação de Recursos/economia , Impostos/economia
6.
Cien Saude Colet ; 24(12): 4473-4478, 2019 Dec.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31778497

RESUMO

Throughout the three decades of the Federal Constitution, normative and fiscal redesigns were introduced by the Union in the guarantees of solidary federative organization and of social rights costing, under the pretext of safeguarding the intertemporal sustainability of the Brazilian public debt. In order to equalize the tension between economic stability and the effectiveness of social rights and their repercussion for the indebtedness process, the health and education minimum spending and the social security budget were gradually mitigated, which operated both in the symbolic field and in the pragmatic, as a kind of fiscal balance to the need for allegedly unlimited cost for monetary and cambial policies. Unlink taxes, reduce the scope of minimum spending regimes and restrict the interpretative scope of intergovernmental equalization transfers of federative distortions has become a strategy, assumed - directly or indirectly - by the Union since the early 1990s, of macroeconomic stabilization policy, above all, monetary. Thus, a long and still ongoing process of budgetary and financial deconstruction of social rights has been undertaken, which restricts the structural identity of the FC/1988, under the pretext of increasingly demanding fiscal consolidation of the reduction of the size of the state.


Assuntos
Orçamentos/legislação & jurisprudência , Governo Federal , Financiamento da Assistência à Saúde , Direitos Humanos/legislação & jurisprudência , Brasil , Educação/economia , Educação/legislação & jurisprudência , Direitos Humanos/economia , Humanos , Previdência Social/economia , Previdência Social/legislação & jurisprudência
9.
Rev Saude Publica ; 53: 58, 2019 Jul 18.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31340350

RESUMO

To advance in order to overcome the challenge of enabling greater autonomy in the use of financial resources in the Unified Health System (SUS), system managers agreed that transfers from the Union to other federated entities will be carried out through a financial investment account and a costing account. Over the past few years, states and municipalities managed more than 34,000 bank accounts dedicated to the Union's on-lendings, in which balance exceeded R$8 billion. However, from 2018, Ordinance 3,992/2017 unequivocally separated the budget flow from the financial flow, and the fund-to-fund transfers started to be carried out in only 11,190 bank accounts. Since then, managers have had financial autonomy in the management of financial resources received from the Union, if in accordance with the parameters established in their respective budget items at the end of each fiscal year.


Assuntos
Orçamentos/legislação & jurisprudência , Orçamentos/organização & administração , Gastos em Saúde/legislação & jurisprudência , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/legislação & jurisprudência , Brasil , Orçamentos/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Humanos , Programas Nacionais de Saúde/organização & administração , Setor Público/economia , Setor Público/legislação & jurisprudência , Setor Público/organização & administração
19.
J Community Psychol ; 47(3): 462-476, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30238530

RESUMO

Participatory budgeting [PB] is a democratic process whereby community members determine how to spend governmental funds. Youth-led PB is relatively new, occurring in select U.S. cities. During youth-led PB, youth collect ideas, develop proposals, and advertise community improvement projects for which they, citywide, cast deciding votes. The study examined opportunities for the empowerment youth at each stage of a youth-led PB project. Data collection included individual interviews with 31 youths and adult stakeholders, 3 focus groups with youths, and 7 observations of meetings. The data were analyzed using consensual qualitative research methods. Findings align well with the psychological empowerment literature and demonstrate several opportunities for empowerment throughout the PB project, including feeling in charge of the process, understanding and allocating resources, and influencing positive community change. Findings also demonstrate potential barriers to empowerment, including understanding bureaucratic decision making, and influencing policy. PB is relevant to furthering our understanding of the empowerment of youth. The youths who participated in the present study expressed feelings of competence, purpose, and an ability to use the skills learned to engage fellow youths in the PB process. Additional empirical research is needed to examine the dimensions of empowerment at each stage of the PB process.


Assuntos
Orçamentos/legislação & jurisprudência , Participação da Comunidade/métodos , Empoderamento , Política , Adolescente , Adulto , Boston , Criança , Pesquisa Participativa Baseada na Comunidade/economia , Tomada de Decisões , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Adulto Jovem
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