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Ease hospital wages, update the SUS desk, reduce national money owed; see nursing floor funding proposals discussed | Budget monitoring

Congress is dashing forward of the Oct. 2 election to attempt to approve an alternative choice to funding the minimal wage for nurses.

Among the proposals on the desk are: exempting non-public hospitals from payroll, updating the SUS fee desk and creating compensation for states and municipalities. These three have been discussed in a gathering final week between Senate President Rodrigo Pacheco (PSD-MG) and Minister Luis Roberto Barroso of the Federal Supreme Court (STF).

There are additionally concepts in Congress about the way to benefit from the well being lottery funds and oil royalties.

The STF supports the suspension of the nursing floor

The STF helps the suspension of the nursing floor

The floor was authorised by the House and Senate mid-year and sanctioned by President Jair Bolsonaro in August. But Barroso stopped the measure earlier than it took impact.

The minister understood that the mission didn’t point out a supply of funding for the fiscal affect on billionaires that the floor would carry. Municipalities, the state and the non-public sector, which should pay for many of the new floor, say there isn’t a cash.

This Thursday (15), the STF’s digital plenary determined to keep up the suspension imposed by Barroso.

It is necessary for MPs and Senators, even from an electoral standpoint, to discover a technique to fund the floor earlier than the election. During the approval of the proposal, parliamentarians once more emphasised the significance of the function of nurses and assistants throughout the pandemic.

The STF-banned floor supplies the following values:

  • nurses: BRL 4750
  • nurse technicians: 3325 BRL
  • nursing assistants: 2375 BRL
  • midwives: 2375 BRL

Here are the fundamental options Congress is debating:

Exemption from wages

The exemption from sick pay was one among the proposals discussed between Congress President Rodrigo Pacheco (PSD-MG) and Minister Barroso final week.

The downside with this various, in accordance with parliamentarians and specialists, is that it could solely profit the non-public sector.

The payroll tax exemption that presently applies to some sectors permits corporations to exchange the 20% social safety contribution on worker wages with a charge on gross receipts.

There is already a textual content in Congress offering for the inclusion of the hospital sector.

Update SUS desk

Another possibility discussed by Pacheco and Barroso was updating the SUS desk. The desk exhibits the quantities the Union pays states and municipalities to carry out procedures in regional hospital networks.

Updating the desk is an previous request of mayors and district governors.

As for the adjustment to the SUS desk, sources at the Ministry of Economy consider that it could be a rise in necessary spending, which might put stress on the spending ceiling, a rule that limits the progress of Union spending to the earlier 12 months’s inflation.

Compensation for employees

Under this proposal, indebted states and municipalities would have a restoration mannequin much like the compensation made with ICMS assortment loss, additionally authorised this 12 months by Congress.

This proposal authorizes the use of royalties from oil and fuel exploration to pay the nursing floor.

According to the mission, 20% of the union’s revenues from particular participation and royalties will likely be distributed amongst the municipalities. The distribution will comply with the similar guidelines for the distribution of the Municipal Participation Fund (FPM).

Another possibility is to make use of a few of the earnings that may be collected by creating the Health Lottery by means of a invoice handed final month by Congress. According to the textual content, 5% of the results of the assortment of the video games will likely be allotted to the National Health Fund (NHF), in the case of the Health Lottery. The textual content continues to be awaiting approval from the president.

Some parliamentarians additionally argue that the regulation of so-called video games of likelihood – resembling bingo, on line casino and animal video games – may additionally serve to fund the minimal wage for the class.

A proposal pending in Congress would repeal a 1946 regulation that banned playing nationwide.

According to the textual content, the Ministry of Economy will likely be chargeable for formulating insurance policies to prepare the playing and betting market, along with inspecting and supervising the use of those actions in Brazil. The proposal handed the House in February, but it surely doesn’t include a provision that particularly ties the assortment to the new enterprise and floor funding. The textual content awaits evaluation by the Senate.

Another proposal suggests altering the assortment of some taxes in an effort to pay for the floor. The details are:

  • tax on earnings and dividends in the quantity of 12.5%, based mostly on earnings tax;
  • to steadily improve the social contribution charge on web earnings (CSLL) paid by monetary establishments;
  • create a tax to be levied on nice wealth;
  • standardize inheritance tax nationally, which varies from nation to nation.

After the STF shaped a majority to ban the floor, Pacheco mentioned Congress may maintain classes even in these weeks earlier than elections, which isn’t traditional.

“I’ll instantly name a gathering of the leaders and by Monday (19) we’ll current doable options. If essential, we’ll maintain a particular advisory session to contemplate the matter, even throughout election intervals. The problem continues to be a precedence, and Congress’ dedication to nursing stays robust. I hope for a choice quickly,” Pacheco mentioned.

Calculation of the affect on the floor

The Independent Fiscal Institution (IFI), a physique linked to the Senate, estimates that any measures taken by the Union to assist states, municipalities and the non-public sector would value BRL 17.4 billion per 12 months — being BRL 5.4 billion to assist states and municipalities and BRL 11.9 billion to the non-public enterprise sector (BRL 5.9 billion) and non-profit (BRL 6.4 billion).

According to the National Confederation of Municipalities (CNM), the affect of the measure may attain R10.5 billion {dollars} just for municipalities.

Hospital and state and municipal entities say that with no designated funding supply, implementation of the floor will result in cuts and impacts on well being care.

The options don’t fulfill the financial system and the municipalities

Behind the scenes, technicians from the financial staff have been sad with the measures being discussed. As for the purse, the Legislature and the Judiciary throw the invoice for the nursing floor into the lap of the Union and that thus “it’s tough to keep up fiscal accountability.”

Representatives of the municipalities additionally take into account the measures inadequate. Paulo Zulkoski, president of the National Confederation of Municipalities (CNM), says the mission to control playing, for instance, is “silly” and “populist”.

Regarding the update of the SUS desk, Zyulkosk says that the measure is of “excessive want” however is not going to meet the necessities of the municipalities in relation to this particular expenditure.

According to him, most Brazilian cities handle major care in well being posts, UPA and agreements with the third sector, by means of social well being organizations (OSS).

The SUS desk, on the different hand, is principally used to pay for procedures of medium and excessive complexity.

The correction of the desk, in accordance with the mayors, is not going to make it financially simpler for the mayors to pay the floor of the nurses directed to major care.

The aim of managers is to hunt a everlasting supply of compensation for this new expense. One of the prospects discussed is the growth of transfers by means of the Municipal Participation Fund (MPF). In 2021, Congress handed a proposed constitutional modification (PEC) that elevated FPM transfers by one proportion level, which right this moment quantity to 23.5% of all federal earnings tax (IR) and industrialized product (IPI) taxes .

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