How is the public long-term care system financed? | Brazil How is the public long-term care system financed? | Brazil

31 Mar 2022

Although there has been an increase in the development of inter-sectoral policies that establish how and to whom health and social care services should be delivered/accessed in Brazil (e.g., integrated care for older people) (Brazilian Ministry of Health, 2018e), LTC is not a unified system in Brazil and the financing of such services is separate via health and social care ministries. As detailed in item VII: health-system financing, the three spheres of government in Brazil (federal, state, and municipal) are responsible for financing SUS, and a similar strategy is used within SUAS. Monetary resources allocated to each of these systems are directly transferred from the federal government to states, municipalities and the federal district, which results in decentralized and participatory management of public resources (laws 8742/93 and 8.080/90). Financing of such systems also occur via state and municipal taxation and each sphere of government manages their resources in line with some common shared responsibilities (Brasil, 1990, 1993).

In 2011, only six years after the implementation SUAS, the law 12.435/11 replaced the law 8.742/93 and established a system to regulate the organisation and provision of social assistance. This includes rules of social control, monitoring, evaluation, and management of SUAS, coordinated by the Ministry of Citizenship and in partnership with states, the Federal District and municipalities. This set of standards and rules introduced a new form of social assistance, breaking with a previous vision centred on charity and favour and establishing regular funding for social care (Brasil, 2011). In 2010, nearly R$11 billion was invested in assisting 1.62 million older people, which represented a growth percentage of 365% in the volume of funds invested and 177.7% in the total number of beneficiaries in relation to 2002 (Brasil, 2011).


Brazilian Ministry of Health. (2018e). Orientações Técnicas para a Implementação de Linha de Cuidado para Atenção integral à Saúde da Pessoa Idosa no Sistema Único de Saúde—SUS. Ministério da Saúde do Brasil.

Brasil, no. 8080/90 (1990). http://www.planalto.gov.br/ccivil_03/leis/l8080.htm

Brasil, no. L8742 (1993). http://www.planalto.gov.br/ccivil_03/leis/l8742.htm

Brasil, no. L12435 (2011). http://www.planalto.gov.br/ccivil_03/_ato2011-2014/2011/lei/l12435.htm