FISCAL POLICY, CRISES AND HEALTH EXPENDITURE OF THE UNION: ANALYSIS OF THE PERIOD 2010–2024

Abstract

This article analyzes the evolution of federal health expenditures in Brazil from 2010 to 2024, based on data from the Annual Budget Law (Lei Orçamentária Anual – LOA), deflated by the IPCA with 2024 as the base year. The objective is to identify real trends, variations, and inflection points associated with changes in the fiscal policy framework and extraordinary events, such as the COVID-19 pandemic. The methodology consists of a quantitative, descriptive, and exploratory study using secondary data extracted from the SIGA Brasil platform and organized as a historical time series. The results indicate the persistence of health underfunding as a State policy, with limited real growth between 2010 and 2014, stagnation and real losses during the period of the Expenditure Ceiling (2016–2019), and extreme volatility during the pandemic, marked by an emergency expansion followed by a sharp contraction. From 2023 onward, a real recovery in health spending is observed, associated with the replacement of Constitutional Amendment No. 95/2016 by the New Fiscal Framework. The study concludes that, although the recent budget increase represents an institutional advance, the effects of a prolonged cycle of fiscal austerity continue to constrain the structural capacity of the Brazilian Unified Health System (SUS), reinforcing the need for stable, planned, and equity-oriented health financing.