02.02.01. How is the health system financed? | Brazil

02.02.01. How is the health system financed? | Brazil

31 Mar 2022

The Brazilian health system is financed through taxes, social contributions (taxes for special programmes), out-of-pocket spending, and employers’ healthcare contributions (Paim et al., 2011). The financing of the SUS is funded by the public sector through three levels of governance (federal, states, and municipalities) and it is guaranteed by the Federal Constitution of 1988 (Presidency of Republic of Brazil, 1988). Funding for the SUS comes from tax revenues and social contributions of the federal government, and from state, and municipal budgets (Paim et al., 2011). The federal government is the main financing body and follows a calculation based on GDP that reveals the percentage to be invested in SUS per year (Presidency of Republic of Brazil, 2012, p. 141).

According to the Law N. 141 (2012), states and municipalities must invest a minimum of 12% and 15% of their revenue in SUS, respectively (Presidency of Republic of Brazil, 2012). However, funding for the SUS has not been enough to ensure adequate or stable financial resources for the public system (Paim et al., 2011). The private health sector is financed both by the SUS (via services contracted-out by the public health system) and by private sources such as individuals who make out-of-pocket payments for private health services and employer’s healthcare contributions. Data show that in 2017, private health services accounted for 66.8% of families’ health-related expenditure (Brazilian Institute of Geography and Statistics, 2019a).


Brazilian Institute of Geography and Statistics. (2019a). Conta-satélite de saúde: Brasil: 2010-2017. https://biblioteca.ibge.gov.br/index.php/biblioteca-catalogo?view=detalhes&id=2101690

Paim, J., Travassos, C., Almeida, C., Bahia, L., & Macinko, J. (2011). The Brazilian health system: History, advances, and challenges. The Lancet, 377(9779), 1778–1797. https://doi.org/10.1016/S0140-6736(11)60054-8

Presidency of Republic of Brazil. (1988). Federal Constitution of Brazil. http://www.planalto.gov.br/ccivil_03/constituicao/constituicao.htm

Presidency of Republic of Brazil. (2012). Lcp 141. http://www.planalto.gov.br/CCIVIL_03/LEIS/LCP/Lcp141.htm

Projeto de Lei do Senado n° 74, de 2014. (2014). https://www25.senado.leg.br/web/atividade/materias/-/materia/116394