The Health Fund and its appropriation by Social Organizations in the municipality of São Paulo

ABSTRACT The Health Fund of the municipality of São Paulo has been discussed, highlighting the appropriation of its resources by the private sector, especially by Social Organizations (OS). To this end, the first part presents the more general foundations of the Public Fund. The second part analyzes the historical trajectory of the Municipal Health Fund and the use of its resources, to a large extent, to finance primary care, via the Family Health Program executed by the OS. The third part presents the characteristics of the OS, analyzing the evolution of the appropriation of resources of the Health Fund between 2011 and 2021. It can be seen that the Health Fund resources are increasingly appropriated by these private entities, with a growing trend, reaching a level of 89.2% of total resources in 2021. Thus, the movement of implicit mercantilization is verified, marked by the logic of expansion of market mechanisms in the municipal Unified Health System.