The 2027 General National Budget bill provides for an 11.2% increase in public spending and raises the fiscal deficit ceiling to 3.9% of gross domestic product (GDP), but does not include the pay increase demanded by doctors. The proposal was submitted to Congress by Economy and Finance Minister Óscar Lovera on September 1, while the public health system was facing a nationwide strike and mass resignations by specialists.
The plan totals G. 166.322 trillion. Of that amount, G. 87.9 trillion corresponds to the Central Administration and G. 78.4 trillion to decentralized entities. The executive branch would absorb 76% of the overall increase. The government says the higher deficit — above the 1.5% ceiling set by the Fiscal Responsibility Law — will be used to pay accumulated debts to suppliers of medicines, roadworks and other services.
In health care, the proposal allocates G. 18.2 trillion. It also provides about US$760 million for medicines and supplies, approximately US$260 million more than in 2026, as well as US$195 million for the National Cancer Institute (Incan). The package includes holiday pay and the formalization of 2,390 professionals, but leaves out the base-salary increase demanded by doctors.
Lovera said a general pay increase would cost between US$130 million and US$150 million and would be unfeasible under current conditions. The minister advocated negotiations tied to career development and professionalization instead of a uniform adjustment. The bill also provides for the issuance of approximately US$2.1 billion in debt for infrastructure and the regularization of liabilities, which the government estimates at about US$1.27 billion for part of its obligations.
The National Doctors’ Union (Sinamed) ended a five-day strike but submitted mass resignations by specialists from hospitals including the Trauma Hospital, the Niños de Acosta Ñu Pediatric Hospital, Itauguá National Hospital and Incan. The organizations are demanding a pay increase after 14 years without one, reduced excessive working hours and better working conditions. The government is also facing political pressure: pre-candidate Arnoldo Wiens called for Health Minister María Teresa Barán to step down, while lawmaker Rubén Rubín described the budget as a turning point and criticized the growth in public spending.
The crisis is also evident in day-to-day hospital operations. In Ciudad del Este, five babies were transferred from the Regional Hospital’s Neonatal Unit to General Surgery’s Inpatient Room 3 after a flea infestation was detected. The area remained closed after new insects were found during fumigation and disinfection. Health workers also reported problems with the sewage system, water seepage, leaks and a lack of a permanent cleaning team in critical areas. Hospital director Cristian Martínez did not respond to contact attempts recorded in the report.
The budget will now be reviewed by the Bicameral Budget Commission and then debated by both houses of Congress. For patients, the dispute will have tangible effects as the bill moves forward: the text promises more resources for medicines and hospital debts, but leaves unresolved the retention of specialists — precisely the staffing component that supports high-complexity services.