Economic crisis and disparities in spending, supply, and use of public and private health services in Brazil from 2011 to 2019

This study sought to analyze the repercussions of the economic crisis on the public and private sec-tors of the Brazilian health system and perform a trend analysis of economic and care indicators, based on secondary data from official public sourc-es related to spending, the economic performance of health plans and insurance, and the supply and use of services. The results showed stagnation of public spending on health, as well as reduction of per capita public spending and of access to public health services. On the contrary, in a context of falling income and employment, health plans re-tained customers, increased revenues, profits, and their care production. The positive performance of companies, before and after the crisis, can be explained by the trend of maintaining public sub-sidies for the private sector and by financialized business strategies. We conclude that the actions of the Brazilian government during the crisis deep-ened the restriction of resources to the public sec-tor and favored the expansion of private services, which thus contributed to increase the discrepancy in access to public and private health services in the country.