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S u m \u00e1 rio
E x e c u tiv o
A .
o
p re s e n te
R e L a t\u00f3 -i::
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G o v e rn o
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r e a liz a r
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a e rrc "'u n d a d a
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s is te m \u00e1 tic a
s o b re
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d e
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p e r\u00edo d o
d e
1 S E D :3
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g a s to s
p \u00fa b lic o s
c o m
s a \u00fa d e
fa ::s
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2 0 0 4 ).
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d e
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S N S .
A
m a n u te n \u00e7 \u00e3 o
d o s
r1 :r:--::s
-
" '- - -
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_
c o n fig u ra
um a
s itu a \u00e7 \u00e3 o
d e
IT :S ';3 :S -:3 ::
- - - - - -
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n e c e s s id a d e s
c re s c e n te s
N -
a d e q u a d a
o r g a n iz a \u00e7 \u00e3 o
n a
C 8 ~ '~ :::\u00aa:- - - ---
E .
_ J
I
1
i
I
j
1 1:
1
j
)
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F. Em
P o rtu g a l, o e n fo q u e
d a s p o l\u00edtic a s
de sa\u00fade
n \u00e3 o s e te m
s itu a d o
n a c o n te n \u00e7 \u00e3 o
d e c u s to s , e m b o ra v \u00e1 ria s m e d id a s to m a d a s
a p a rtir d o
a n o
2 0 0 0
p o s s a m
vir a ter um
im p a c to
im p o rta n te
n e s te
d o m \u00edn io ,
m a s a in d a n \u00e3 o d e v id a m e n te
q u a n tific a d o .
G. As
d e s p e s a ~ J ;> Iiv a d a s
d o s
c id a d \u00e3 o s
re s id e n te s
e m
P o rtu g a l
c o m
e rltid ~ iid e s ~ p rlv a d a s re p re s e n ta ra m
c e rc a d e 2 ~ ,5 ~
da despesa
to ta l
e m
s a \u00fa d e
e m
2 0 0 4 .. E s te
v a lo r
c o n tra s ta
fo rte m e n te
c o m
o s
p a g a m e n to s
d ire c to s
d a s
fa m \u00edlia s
e m
s e d e
d e
p re s ta \u00e7 \u00e3 o
p \u00fa b lic a ,
in fe rio re s
a 1 % . R e s s a lta
d a q u i q u e o s c o -p a g a m e n to s
e x ig id o s
\u00e0 s
fa m \u00edlia s
n a p re s ta \u00e7 \u00e3 o
p \u00fa b lic a t\u00ea m
u m a m u ito re d u z id a e x p re s s \u00e3 o
e m
te rm o s
d e
c o n tr ib u i\u00e7 \u00e3 o
p a ra
o
fin a n c ia m e n to .
\u00c9
n o
s e c to r
d g
m e c lic a m e n to g ~ e a
o p a r tic ip a \u00e7 \u00e3 o
.? O S
u te n te s -'\u00e9 re l\u00e3 T iV a m -e n te
e le v a e fa , o ~ q U es ed e v e ,
p o r u m la d o , oa ta x a s d e c o m p a rtic ip a \u00e7 \u00e3 o
c o m p a ra tiv a m e n te
b a ix a s ,
c o m
p o u c a s
is e n \u00e7 \u00f5 e s
d e p a g a m e n to ,
e
p o r
o u tro
la d o , a
n \u00edv e is
d e
u tiliz a \u00e7 \u00e3 o
d e
f\u00e1 rm a c o s
re l-a tiv a m e n te
e le v a d o s .
A
a n \u00e1 lis e
d o s
d a d o s
d e
in q u \u00e9 r ito s
a o s
o r\u00e7 a m e n to s
fa m ilia re s
d e m o n s tro u
a in d a
q u e
o s p a g a m .e J :1 J Q s
od ire c to s ,
na sua
g lo b a Iid a d e ,.~ ~ 9 .~
l~ a rl'1 ~ llt~ _ r~ .lJ I~ s s jy \u00ba .s _ m )fi
n c ~ n g jam e n to d o s is te m a .
H. Os
s u b s is te m a s
d e
s a \u00fa d e
t\u00ea m
s o frid o
um a
e le v a d a
p re s s \u00e3 o
n o s
c u s to s
e e s t\u00e3 o
d e p e n d e n te s
d e
um a
c o m p o n e n te
s ig n ific a tiv a
d e
fin a n c ia m e n to
d o
E s ta d o
e
d a s
em presas.
T \u00ea m
p ro c u ra d o
im p le m e n ta r
u m
c o n ju n to
d e
m e d id a s ,
d e
fo rm a
a
c o n tro la r
a
u tiliz a \u00e7 \u00e3 o
e
o
g a s to ,
e
a
a u m e n ta r
a s
c o n tr ib u i\u00e7 \u00f5 e s
d o s
s e u s
b e n e fic i\u00e1 r io s .
Q \u00a7 ._ ~ 9 lJ .\u00a7 is te m a s
p riv a d o s
t\u00ea m
m a n ife s ta d o
u m
d e s in te re s s e
p o rc o n s titu ir-s e
n u m a 9 lt~ rtl\u00aa th ~ \u00aa .g .~ o c o Q ~ rtu ra in te g ra l
ao SNS~o0 0 -\u00b7
. . .
.
I .
9
m e rc a d o
d e
s e g u ro s
v o lu n t\u00e1 r io
te m
re g is ta d o
um a
e x p a n s \u00e3 o
b a s e a d a
n a c o m p le m e n ta r ia a d e
dos seus
p ro d u to s
e m
re la \u00e7 \u00e3 o
a o
S N S .
E s te
\u00e9
u m
s e c to r
lu c r a tiv o ,
c o m
u m
n \u00edv e l
s u b s ta n c ia l
d e
.
.
c o n c e n tra \u00e7 \u00e3 o ,
q u e
n \u00e3 o
te m
re v e la d o
in te re s s e
e m
s e g u ra r
a s
p ~ p u ~ ~ ~ m -\u00b7
m a io r
n \u00edv e l
a e
ri~ \u00bao ,.
n e m
e J l!.-._ .~ re c e r
e x te n s iv a m e n te
p ro d u to s
p a ra
c o b E ? rtu ra in te g r\u00aaL .s L -a lte rn \u00aativ a
a o
S N S .
.
.
J .
E m
P o rtu g a l,
o
s is te m a
d e
b e n e f\u00edc io s
fis c a is ,
e m
e s p e c ia l
a s
d e d u \u00e7 \u00f5 e s
\u00e0 c o le c ta d e IR S , c a ra c te riz a -s e .R o r re g re s s iv id a d e ,
b e m
. com o
p o r u m a r\u00ea T \u00e3 "tT V a Q e n e ro s id a d e q u a n d o
in s e r id o
e m c o n te x to
in te r n a c io n a l.
L .
A d is c u s s \u00e3 o
d e p o s s \u00edv e is
a lte ra \u00e7 \u00f5 e s
\u00e0 fo rm a c o m o o fin a n c ia m e n to
d o S N S s e e n c o n tra o rg a n iz a d o
gerou duas grandes conclus\u00f5es:
C o n c lu s \u00e3 o
1 :P a r a g a r a n tir a s u s te n ta b ilid a d e
fin a n c e ir a
do SNS
\u00e9
n e c e s s \u00e1 rio
a d o p ta r
d iv e rs a s
m e d id a s
s im u lta n e a m e n te ,
n \u00e3 o
s e n d o id e n tific \u00e1 v e l u m a q u e , p o r s i s \u00f3 , a a s s e g u r e _
. ,
L
l
]
1
J
j
]
]
] 1
li
]
!
i .
J
I
C o n c lu s \u00e3 o
2 :
H \u00e1
um a
g ra n d e
d e p e n d \u00ea n c ia
d a
s u s te n ta b ilid a d e
fin a n c e ir a
d o
S N S
e m
r e la \u00e7 \u00e3 o
a fa c to re s
e x \u00f3 g e n o s
a o
s e c to r
d a
s a \u00fa d e ,
com o
s e ja m
a
e v o lu \u00e7 \u00e3 o
d a
re s ta n te
d e s p e s a
p \u00fa b lic a
e
d a s re c e ita s
d o E s ta d o .
M . Ap\u00f3s
a a p r e c ia \u00e7 \u00e3 o
d a s v \u00e1 r ia s
a lte rn a tiv a s
d e fin a n c ia m e n to
d o
S N S ,
a C o m is s \u00e3 o
re c o m e n d a
a o G o v e rn o :
1 .
M a n u te n \u00e7 \u00e3 o
d o
s is te m a
p \u00fa b lic o
d e
fin a n c ia m e n to
d o
SNS, como
g a ra n tia
d o
s e g u ro
b \u00e1 s ic o
p \u00fa b lic o ,
u n iv e r s a l
e
o b rig a t\u00f3 rio ,
a s s e n te
n o p a g a m e n to
d e im p o s to s .
2 .
A d o p \u00e7 \u00e3 o
d e
m e d id a s
q u e
a s s e g u re m
m a io r
e fic i\u00ea n c ia
n a
p re s ta \u00e7 \u00e3 o
d e
c u id a d o s
d e
s a \u00fa d e ,
tra d u z id a s
por m enor
d e s p e s a
p \u00fa b lic a
e m
s a \u00fa d e
e m e n o r ta x a d e c re s c im e n to .
3 .
U tiliz a \u00e7 \u00e3 o
a b ra n g e n te
d e
m e c a n is m o s
d e
a v a lia \u00e7 \u00e3 o
c l\u00edn ic a
e
e c o n \u00f3 m ic a
p a ra
e s ta b e le c im e n to
d e
p rio rid a d e s
e
d e fin i\u00e7 \u00e3 o
d a s
in te rv e n \u00e7 \u00f5 e s
a s s e g u ra d a s
p e lo s e g u r o
p \u00fa b lic o .
4 .
R e v is \u00e3 o
d o
re g im e
v ig e n te
d e
is e n \u00e7 \u00f5 e s
d a s
ta x a s
m o d e ra d o ra s ,
c o m
um a
s u a
r e d e fin i\u00e7 \u00e3 o
b a s e a d a
e m
d o is
c rit\u00e9 rio s :
c a p a c id a d e
d e p a g a m e n to
en e c e s s id a d e
c o n tin u a d a
d e c u id a d o s
de sa\u00fade.
5 .
A c tu a liz a \u00e7 \u00e3 o
d o
v a lo r
d a s
ta x a s
m o d e ra d o ra s ,
com o
m e d id a
d e
d is c ip lin a .
d a
u tiliz a \u00e7 \u00e3 o
d o
S N S
e
d e
v a lo r iz a \u00e7 \u00e3 o
d o s
s e r v i\u00e7 o s
p re s ta d o s .
.
6 .
R edu\u00e7\u00e3o
d o s
b e n e f\u00edc io s
fis c a is
a s s o c ia d o s
\u00e0 s
d e s p e s a s
e m
s a \u00fa d e ,
a p r o x im a n d o
a
r e a lid a d e
p o rtu g u e s a
d a
o b s e rv a d a
n a
g e n e r a lid a d e
d o s p a \u00eds e s d a O C D E .
7 .
R e tira r
d o
e s p a \u00e7 o
o r\u00e7 a m e n ta l
o s
s u b s is te m a s
p \u00fa b lic o s ,
s e n d o
e v o lu \u00e7 \u00f5 e s
p o s s \u00edv e is
a sua
e lim in a \u00e7 \u00e3 o
ou a sua
a u to -s u s te n ta \u00e7 \u00e3 o
fin a n c e ir a .
N .
N um a
s itu a \u00e7 \u00e3 o
e x tre m a
d e
in s u s te n ta b ilid a d e
fin a n c e ir a
d o
S N S ,
a
C o m is s \u00e3 o
fa z
um a
re c o m e n d a \u00e7 \u00e3 o
e x c e p c io n a l,
q u e
s e
tra d u z
n a
im p o s i\u00e7 \u00e3 o
d e c o n tr ib u i\u00e7 \u00f5 e s
c o m p u ls \u00f3 r ia s ,
te m p o r\u00e1 ria s ,
d e te rm in a d a s
p e lo
n \u00edv e l d e
re n d im e n to ,
u tiliz a n d o
o s is te m a
fis c a l e d ir e c c io n a n d o
a s v e rb a s
o b rig a to ria m e n te
p a ra o S N S .
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