Sustentabilidade financeira e econômica do gasto público em saúde no nível municipal: reflexões a partir de dados de municípios mato-grossenses

O financiamento do SUS é regido pelo modelo de federalismo fiscal, pelas regras de partilha do Orçamento da Seguridade Social (OSS), por normas do Ministério da Saúde, e pela Emenda Constitucional nº. 29 (EC-29), que vincula à saúde recursos dos entes federados brasileiros. Discute-se aqui a sustentabilidade do gasto público com saúde no nível municipal. Foram estudados 21 municípios, utilizando-se dados dos balanços municipais. De 1996 a 2006 as receitas correntes gerais per capita subiram 280% acima da inflação acumulada e do Produto Interno Bruto (PIB) nacional, variando conforme o porte do município, o qual também definiu a composição dos orçamentos municipais. Já o orçamento que conforma a base da EC-29 elevou-se bem menos (178%), impondo limitações ao incremento da contrapartida municipal em saúde. Acredita-se que o observado nesses municípios se reproduza em milhares de municípios brasileiros e comprometa a capacidade de investimento municipal em saúde, principalmente a partir de 2008. A situação ainda pode se agravar tendo em vista a extinção da Contribuição Provisória sobre a Movimentação ou Transmissão de Valores e de Créditos e Direitos de Natureza Financeira (CPMF), a tramitação dos Projetos de Lei nº. 306/08 e nº. 233/08, e a recessão mundial, a partir da crise do sistema financeiro norte-americano.

BA'S : The practice and law of bankers' acceptance

Au cours d'une transaction portant sur une acceptation bancaire (ci-après «BA» tel que dénommée dans le jargon juridique) différents types de relations peuvent s'établir entre les parties impliquées, certaines plus directes que d'autres. Dans une transaction donnée, à part le client et la banque, on peut trouver une ou plusieurs banques participantes et un ou plusieurs investisseurs, qui deviennent détenteurs de BA. La situation peut devenir complexe et les relations légales risquent de devenir assez compliquées. Cependant, il est important d'identifier si la relation s'est établie à travers l'instrument de BA, si elle existe par le biais d'une relation contractuelle ordinaire ou encore, si elle existe par le fait de la loi. Une bonne analyse des circonstances entourant la transaction, des facteurs connexes à la transaction et des droits et obligations qui existent entre les parties, sera nécessaire pour déterminer laquelle de la loi provinciale ou fédérale s'appliquera, et dans quelle mesure. Une fois accordée, la BA est gouvernée par la Loi sur les lettres de change. Toutes solutions apportées à un problème qui implique des BA, doivent, en principe, respecter la nature inhérente de la BA en tant qu'effet de commerce, gouverné par la loi fédérale. En matière de BA, c'est, soit la Loi sur les lettres de change soit la Loi sur les lettres et billets de dépôt (Depository Bills and Note Act) qui s'appliqueront à l'acte. Comme il existe des lois fédérales applicables à la BA, l'objet de notre étude est de déterminer si, et dans quelle circonstance la loi de la province, tel que le Code civil du Québec, trouvera application et éclaircira dans certains cas la disposition contenue dans la Loi sur les lettres de change, notamment lorsque les dispositions de ladite loi sont silencieuses ou ambigües. La solution la plus simple serait d'appliquer la loi provinciale aux matières qui ne sont pas traitées dans la loi, étant donné que les lois provinciales apportent souvent un complément à la législation fédérale. Cependant, la Loi sur les lettres de change contient des dispositions spéciales, tel que l'article 9 qui stipule : « 9. Les règles de la common law d'Angleterre, y compris en droit commercial, s'appliquent aux lettres, billets et chèques dans la mesure de leur compatibilité avec les dispositions expresses de la présente loi. » Cette disposition a crée une certaine confusion relativement à l'application du droit civil du Québec en matière de Lettres de change. En effet, il existe un doute quant à savoir si l'application de l'article 9 est une incorporation par référence qui exclue totalement l'application du droit civil. Cette question continue de se poser inexorablement dans la doctrine et la jurisprudence. Elle a en effet donné lieu à une série de théories quand au degré d'application de la common law en matière de lettres de change. Une revue de la jurisprudence dominante nous permet de conclure que les tribunaux ont accepté l'application du droit provinciale dans certaines questions impliquant les lettres de change. La question essentielle traitée lors de notre analyse est la suivante: lorsqu'un litige prend naissance dans une transaction de BA, quelle est la règle qui devra s'appliquer? Quel sera le droit qui gouvernera les problèmes émergeant dans une BA, celui du Code Civil du Québec ou celui de la common law d'Angleterre? Étant donne le nombre de cas qui sont portés devant les cours de justice en rapport avec des transactions de BA, comprendre quelle sera la loi applicable est d'une importance fondamentale. Pour répondre à cette question, nous commencerons par un examen de l'historique, du développement et de l'évolution de la BA. Afin de mieux comprendre la BA, nous débuterons par un bref survol des origines de cet instrument juridique. Dans le deuxième chapitre, nous analyserons la nature et le caractère légal de la BA. Cela constituera le cadre aux travers duquel nous pourrons identifier les règles et les principes qui s'appliquent aux différents aspects de la transaction de BA. Le chapitre trois fera l'objet d'un examen détaillé des mécanismes de l'opération de BA tout en étudiant de près les exigences imposées par la législation applicable. Après avoir examine l'aspect légal de la BA, nous procéderons au chapitre quatre, à l'étude de l'applicabilité de la loi provinciale relativement à certains aspects de la transaction de BA. A cet effet, nous examinerons les différentes approches de compréhension de la Loi sur les lettres de change et plus particulièrement la problématique rencontrée à l'article 9. Nous étudierons aussi l'application et l'interprétation de cette loi par les tribunaux du Québec au cours du siècle dernier. Les juges et les juristes se sont penchés sur les sens qu'a voulu donner le législateur lorsqu'il a stipulé dans l'article 9 «Le règles de la common law d'Angleterre, y compris en droit commercial, s appliquent aux lettres, billets et chèques dans la mesure de leur compatibilité avec les dispositions expresses de la présente loi ». Cette section doit-elle être appliquée à la lettre, nous obligeant à appliquer la common law d'Angleterre a chaque problème qui peut se poser en relation avec les lettres et les billets? Le Parlement a-t-il l'intention que cette disposition s'applique également au Québec, dont le droit privé est basé sur le système du Code Civil? Notre étude portera sur les différentes approches d'interprétation qui offrent une diversité de solutions au problème posé par l'article 9. Finalement, compte tenu des nouveaux développements législatifs, au chapitre cinq, nous proposons une méthode en vue de déterminer la loi applicable aux différents aspects de la transaction de BA. Notre analyse nous a conduit à adopter la solution proposée par la majorité des juristes, à la différence que notre approche de l'article 9 est basée sur des raisons de politique. Nous avons donc adopté la stricte dichotomie (en tant qu'effet négociable d'une part, et d'une sorte de contrat et de propriété de l'autre) en prenant en compte les difficultés inhérentes à déterminer quand l'un finit et l'autre commence. En conclusion, selon notre opinion, il existe deux solutions. Premièrement, il y a la possibilité que l'article 9 puisse être écarté. Dans ce cas, toutes les matières qui ne sont pas expressément évoquées dans la loi tomberont dans la compétence de la loi provinciale, comme c'est le cas dans d'autres types de législations fédérales. Dans ces situations, le droit civil du Québec joue un rôle supplétif dans les applications d'une loi fédérale au Québec. Deuxièmement, modifier l'article 9 plutôt que d'en écarter son application offre une autre possibilité. Incorporer la large stricte dichotomie dans l'article 9 nous semble être une solution préférable. La disposition pourrait se lire comme suit: « Les règles de la common law d'Angleterre incluant le droit commercial dans la mesure ou elles ne sont pas incompatibles avec les dispositions expresses de la Loi, s’appliquent aux lettres, billets, et chèques au sens stricte. Pour plus de certitude, les lettres et les billets au sens strict, incluent la forme, la délivrance et I’émission des lettres, billets, et chèques.» Ce type de changement se révélera être un pas important dans le but de clarifier la loi et déterminer l'équilibre à trouver entre l'application des lois fédérales et provinciales en matière de BA.

Benefits and challenges of supply chain finance business process automation : A case study in ING Bank

Supply chain finance, a financial product provided by the bank, has gained increasing attention and popularity over the last few years. Supply chain finance helps the corporate clients to optimize their financial flows along the supply chain. One characteristic of supply chain finance is that it aims to provide automated solutions. Therefore, the business process automation of supply chain finance is a very interesting and important topic for study. In this study, the business process automation of supply chain finance within the case organization, ING, is analysed. The purpose is to: (1) Identify the benefits to understand the importance to automate supply chain finance business process; (2) Find out the existing automation degree in the supply chain finance business process within the case bank to see what’s the situation now and how to improve in the future; (3) Discover the challenges in the further automation of supply chain finance business process. Firstly, the study finds out that supply chain finance business process automation can bring many benefits to the bank. Automation can improve productivity by using less time and human labour in the business process, and by providing scalable solutions. Automation can also improve quality of the service by reducing the human errors. Last but not least, automation can improve internal governance by providing enhanced visibility of the business process. Because of these potential benefits, many banks are actively seeking solutions to automate their supply chain finance business process. Then, the current automation situation with the case bank is analysed with the help of business process modelling. The supply chain finance business process within the case bank can be further divided into several sub processes: daily transaction, buyer sales and setup, supplier onboarding, contract management, customer services and supports, and contract termination. The study finds out that the daily transaction process is already a highly automated, which is carried out through the web-based trading platform. However, for other business the automation degree is relatively low. Among these business processes, supplier onboarding is most needed for further automation. Then, some solutions are also suggested to automate the supplier onboarding business process. In the end, the study also foresees some challenges during the further automation of supply chain finance business process in the case bank. Some suggestions are also given to deal with these challenges.

A Study of Credit Guarantee Fund Trust for Micro and Small Enterprises with particular reference to Bank of Baroda in state of Kerala

While the quantum of advances from the public sector banks (PSBs) to the MSEs has increased over the years in absolute terms, from Rs.46, 045 crore in March 2000 to Rs.1, 85,208 crore in March 2009, the share of the 7credit to the MSE sector in the Net Bank Credit (NBC) has declined from 12.5 per cent to 10.9 per cent. Similarly, there has been a decline in the share of micro sector as a percentage of Net Bank Credit (NBC) from 7.8 per cent in March 2000 to 4.9% in March 2009. (TKA.Nair, 2010)9.The major reasons for low availability of bank finance to this sector are high risk perception of the banks in lending to MSEs and high transaction costs in processing of loan applications of MSEs. The problem is more serious for micro enterprises requiring small loans and the first generation entrepreneursThe thesis studies the divergence in guidelines by, CGTMSE, RBI & Bank of Baroda on collateral free lending and analyses the awareness of MSE about CGTMSE lending. The researcher tries to assess the problems faced by borrowers in availing advance under CGTMSE from Bank of Baroda, Kerala.

Training to address attitudes and behaviour of rural bank managers in Madhya Pradesh, India: A programme to facilitate financial inclusion

Given their physical presence in India, banks are arguably well-placed to improve financial inclusion in rural areas. However, uncertain repayment capacities and high transaction costs mean formal financial institutions are often reluctant to lend to the rural poor. Conversely, high transaction costs in dealing with banks are also incurred by clients, through, for example, lengthy, cumbersome and potentially ignominious procedures. Negative attitudes towards poor clients can be an important component of such transaction costs. An applied research project funded by the Enterprise Development Innovation Fund (EDIF-DFID) developed an innovative training programme designed to encourage more positive attitudes of bank staff towards poor clients, and towards their own role in rural poverty alleviation and development. This paper examines the development of the training programme, its implementation, and the results of its evaluation. It is shown that training can bring about attitudinal change, which in turn is reflected in behaviour and social impact.

Training to address attitudes and behaviour of rural bank managers in Madhya Pradesh, India: a programme to facilitate financial inclusion

Given their physical presence in India, banks are arguably well-placed to improve financial inclusion in rural areas. However, uncertain repayment capacities and high transaction costs mean formal financial institutions are often reluctant to lend to the rural poor. Conversely, high transaction costs in dealing with banks are also incurred by clients, through, for example, lengthy, cumbersome and potentially ignominious procedures. Negative attitudes towards poor clients can be an important component of such transaction costs. An applied research project funded by the Enterprise Development Innovation Fund (EDIF-DFID) developed an innovative training programme designed to encourage more positive attitudes of bank staff towards poor clients, and towards their own role in rural poverty alleviation and development. This paper examines the development of the training programme, its implementation, and the results of its evaluation. It is shown that training can bring about attitudinal change, which in turn is reflected in behaviour and social impact. Copyright © 2007 John Wiley & Sons, Ltd.

Comparative efficiency analysis of Portuguese bank branches

The advent of Internet banking and phone banking is changing the role of bank branches from a predominantly transaction-based one to a sales-oriented role. This paper reports on an assessment of the branches of a Portuguese bank in terms of their performance in their new roles in three different areas: Their efficiency in fostering the use of new transaction channels, their efficiency in increasing sales and their customer base, and their efficiency in generating profits. Service quality is also a major issue in service organisations like bank branches, and therefore we analyse the way this dimension of performance has been accounted for in the literature and take it into account in our empirical application. We have used data envelopment analysis (DEA) for the different performance assessments, but we depart from traditional DEA models in some cases. Performance comparisons on each dimension allowed us to identify benchmark bank branches and also problematic bank branches. In addition, we found positive links between operational and profit efficiency and also between transactional and operational efficiency. Service quality is positively related with operational and profit efficiency. © 2006 Elsevier B.V. All rights reserved.

New insights on measuring bank branches efficiency through DEA:transactional, operational, and profit assessments

This thesis presents a number of methodological developments that were raised by a real life application to measuring the efficiency of bank branches. The advent of internet banking and phone banking is changing the role of bank branches from a predominantly transaction-based one to a sales-oriented role. This fact requires the development of new forms of assessing and comparing branches of a bank. In addition, performance assessment models must also take into account the fact that bank branches are service and for-profit organisations to which providing adequate service quality as well as being profitable are crucial objectives. This study analyses bank branches performance in their new roles in three different areas: their effectiveness in fostering the use of new transaction channels such as the internet and the telephone (transactional efficiency); their effectiveness in increasing sales and their customer base (operational efficiency); and their effectiveness in generating profits without compromising the quality of service (profit efficiency). The chosen methodology for the overall analysis is Data Envelopment Analysis (DEA). The application attempted here required some adaptations to existing DEA models and indeed some new models so that some specialities of our data could be handled. These concern the development of models that can account for negative data, the development of models to measure profit efficiency, and the development of models that yield production units with targets that are nearer to their observed levels than targets yielded by traditional DEA models. The application of the developed models to a sample of Portuguese bank branches allowed their classification according to the three performance dimensions (transactional, operational and profit efficiency). It also provided useful insights to bank managers regarding how bank branches compare between themselves in terms of their performance, and how, in general, the three performance dimensions are connected between themselves.

Iron concentrations in breast milk and selected maternal factors of human milk bank donors

FAPESP n. 03/04061-2

INSTITUTIONAL DEVELOPMENT THROUGH POLICY-MAKING A Case Study of the Brazilian Central Bank

A number of contemporary studies rightly emphasize the notion that policy outcomes result from institutional determinants. But as a growing literature on institutional development notes, these institutions are themselves impermanent. Sometimes, in crisis moments, institutions are replaced wholesale. More frequently, institutions evolve gradually over time. Using the Brazilian Central Bank as a case study, this article illustrates that the policy-making process itself can be a central driver of gradual institutional development, with institutions evolving through the accumulation of policy choices made over many years and under different policymakers in response to contemporaneous events and unforeseeable economic and political challenges.

Human immunodeficiency virus test-seeking blood donors in a large blood bank in Sao Paulo, Brazil

BACKGROUND: Persons with human immunodeficiency virus (HIV) risk behaviors are excluded from donation to reduce the risk of transfusion-transmitted infection. Persons donating to be tested for HIV may therefore deny risk behaviors. STUDY DESIGN AND METHODS: A random sample of donors completed a survey on motivations, knowledge, and attitudes on the screening process. Donors were considered test seekers if they agreed with two statements ""I think that blood donation is a good, fast, and anonymous way to get my blood tested"" and ""I donate to get my test results."" This study was conducted from June to November 2006 at the largest blood bank in Sao Paulo, Brazil. RESULTS: Of 3061 participants, 208 (7%) were test seekers. They tended to be male and had a lower educational level. They were more likely to have incorrect knowledge about blood safety (e.g., not knowing that a unit can test antibody negative and still transmit infection, 60% vs. 42%, p = 0.02), express dissatisfaction with screening questions (e.g., feeling that important questions were not asked, 14% vs. 5%, p < 0.01), and concur that donors do not answer questions truthfully (e.g., donors have more sexual partners than they admit, 29% vs. 18%, p < 0.01). Test seekers were more likely to believe that it is acceptable to donate blood to get tested for HIV (41% vs. 10%, p < 0.01). CONCLUSIONS: Test-seeking motivation, coupled with low knowledge of window period risk, is counter to improving blood safety and to donor prevention needs. Donor education needs to be improved along with availability of appropriate HIV counseling and testing.