Uma década em disputa: trajetória e inflexões do orçamento federal da saúde no Brasil (2013–2023)

This study examines the trajectory of Brazil’s federal health budget from 2013 to 2023, focusing on its variations and implications for financing the Unified Health System. Secondary data from the Integrated Financial Administration System and the Federal Budget Panel were analyzed, adjusted for inflation up to December 2023. The findings show a decade of budget stagnation: total federal health expenditures in 2023 (R$ 182.6 billion) grew only 2.5% in real terms compared to 2013. The health sector’s share of the federal budget fell from 6.03% in 2013 to 5.65% in 2023. Primary Health Care showed the largest proportional increase (38.6%), while hospital and outpatient care remained stable. These trends reveal fiscal constraints that undermine the SUS’s capacity to meet rising health demands, driven by an aging population and the growing burden of chronic diseases. Strengthening public health financing and reaffirming health as a fiscal and political priority are essential to ensure the system’s resilience and long-term sustainability.