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The aim was to analyze how the resources that were allocated by the three spheres emenda constitucional 20 government were used on a general basis and in specific regions.

Analysis was also conducted on the possible repercussions of the Amendment in the allocation of finances for SUS.


There was also more participation from the States, the Federal District and the Municipalities in financing the system.

However, in spite of the increase in the use of financial resources, regional inequalities, in relation to spending per capita, remained practically unchanged.

This is the case even though these resources have become more available recently and especially emenda constitucional 20 the approval of Constitutional Amendment 29 in With the approval of Amendment 29 both the States and the Municipalities had their participation in the financing of their health services linked to their emenda constitucional 20 revenues.

This was due emenda constitucional 20 differences in relation to designated percentages in Amendment 29 that required there to be an increase of a fifth every year Melamed C, Piola SF, organizadores.

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From the minimum value was set based on the year value given by the Health Ministry, with an adjustment due to variations emenda constitucional 20 the GDP in the then previous two years. It was noted that after the approval of the amendment, there was a significant increase in designated financial resources for the National Health Service.

Nevertheless the impact that the Amendment made, differed from region to region, which will be shown later in this paper. One of the least explored areas of research was the repercussions of the regional allocations in public financial resources that occurred due to Amendment Emenda constitucional 20 was done to see whether the implementation of the Amendment, based on data from tohad an effect in reducing the inter-regional inequalities with reference to the allocation of public finances for health.

This was emenda constitucional 20 aim of the text.

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Thus the purpose of emenda constitucional 20 paper is to show that the implementation of Amendment 29 was effective in increasing spending on health. The same cannot be said with reference to reducing regional inequalities. This reduction would only be possible if the Union were to increase its participation through providing finances to cover the expenses for health care services public health care services hereafter will be referred to as ASPS for the poorest regions in the Federation.

This emenda constitucional 20 that the increase in the ASPS expenses was financed by financial resources from the States and Municipalities. This in turn weakened the idea of reducing inequalities. This paper is divided into five sections with the introduction being the shortest.

The second section covers the methodology used and the sources used for this article.

The third section provides details of the public spending that took place on public health care services and activities in Emenda constitucional 20 between and From this we noted that the financial resources which emenda constitucional 20 about due to Amendment 29 provided greater stability for health care financing through designating a continuous increase in this resource.

The fourth section will show that there were regional distributions of specific public funds for health care between andbut despite the increase in the availability of financial resources, there were no significant changes in the positions of some regions.

The fifth section gives our closing considerations. Methodological Aspects The government, through emenda constitucional 20 three emenda constitucional 20, has consolidated public spending and works with the idea that spending should occur on ASPS in accordance with the fifth, sixth and seventh directive in Resolution from the National Health Council published on 8 May Data relating to populations in evaluating public spending throughout different regions and macro-regions, was taken form DATASUS which provided specific demographic and socioeconomic information.

It also did not include: This equates to the expenditure on health care services by the Health Ministry.


The emenda constitucional 20 contains information from the entities that make up the Federation. It was created to monitor and document the expenditure of the three spheres of government in public health care services.

In other words this was data declared by them. The data from the municipalities was consolidated by state and has very good coverage.

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