A judicialização da saúde: os impactos nas políticas públicas no município de Picos-PI e propostas de solução [Digital]
Dissertação
Português
34:614
Fortaleza, 2023.
112f.
A promulgação da Constituição Federal de 1988 inaugurou no Brasil um novo cenário em relação ao direito à saúde. O reconhecimento e a proteção do direito sanitário expõem um bem jurídico de caráter coletivo, que é refletido na esfera individual, o que gera uma necessidade de proteção tanto...
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A promulgação da Constituição Federal de 1988 inaugurou no Brasil um novo cenário em relação ao direito à saúde. O reconhecimento e a proteção do direito sanitário expõem um bem jurídico de caráter coletivo, que é refletido na esfera individual, o que gera uma necessidade de proteção tanto subjetiva, como objetiva. Na contramão daquilo positivado na Lei Maior, pôde-se constatar uma crise no financiamento do SUS, o que gerou aquilo que é designado ¿desfinanciamento¿, fragilizando a aplicação das políticas públicas sanitárias e impulsionando o fenômeno da judicialização, que é o âmago da presente dissertação, que teve como campo de pesquisa e coleta de dados o Município de Picos, com um recorte temporal entre os anos 2012 e 2020. O questionamento central do estudo realizado foi: há despesas contínuas com medicamentos e insumos por determinação judicial? As outras duas questões levantadas dizem respeito ao volume de processos e os impactos efetivos dessas decisões nas políticas públicas no Município de Picos. Constatou-se que judicialização pode provocar uma instabilidade e desequilíbrio no Estado, considerando que o acesso a serviços sanitários deve ser mediante a efetivação de política públicas e não por meio sentenças judiciais. Desenvolveu-se uma análise a cerca do posicionamento do Supremo Tribunal Federal em relação à judicialização da saúde, visto que, ao longo dos anos, um entendimento a respeito desta problemática foi sendo concebido. Por fim, se realizou uma explanação no tocante à realidade fática encontrada no Município de Picos, com relação à judicialização da saúde, analisando-se as despesas contínuas geradas pelas determinações judiciais; o polo passivo das demandas; e o perfil de ingresso dos usuários. Uma abordagem acerca das principais propostas para a solução dos conflitos provenientes da judicialização da saúde foi desenvolvida, de modo que se chegou à conclusão da necessidade de edificação de um novo cenário no Brasil, que, além das possibilidades jurídicas já mencionadas, pode-se considerar também aquilo denominado de ¿desjudicialização da saúde¿ que promove a solução de conflitos por meios alternativos extrajudiciais. Isto posto, a presente dissertação proporá às autoridades sanitárias do Município de Picos a criação de um Comitê Interinstitucional de Resolução Administrativa de Demandas da Saúde, que desempenhará a função de órgão mediador das lides ainda na esfera administrativa e desempenhará também a função de acompanhar os resultados e consequências das decisões proferidas em âmbito judicial.
Palavras-chave: judicialização sanitária; políticas públicas; supremo tribunal federal; consequencialismo; comitê municipal de saúde. Ver menos
Palavras-chave: judicialização sanitária; políticas públicas; supremo tribunal federal; consequencialismo; comitê municipal de saúde. Ver menos
The enactment of the 1988 Federal Constitution inaugurated a new scenario in Brazil
regarding the right to health. The recognition and protection of health law expose a legal good
of common nature, which is reflected in the individual sphere, generating a higher need for
both subjective and... Ver mais The enactment of the 1988 Federal Constitution inaugurated a new scenario in Brazil
regarding the right to health. The recognition and protection of health law expose a legal good
of common nature, which is reflected in the individual sphere, generating a higher need for
both subjective and objective protection. Contrary to what was posited in the Major Law, it
was possible to verify a crisis in the financing of SUS, which generated what is called
"defunding", weakening the application of public health policies and boosting the
phenomenon of judicialization, which is the core of the present dissertation, whose field of
research and data collection was the Municipality of Picos, with a time frame between the
years 2012 and 2020. The central question of the study carried out was: are there continuous
expenses with medicines and supplies by court order? The other two issues raised concern
about the volume of processes and the effective impacts of these decisions on public policies
in the Municipality of Picos. It was found that judicialization can cause instability and
imbalance in the State, considering that the access to health services must be implemented
through public policy and not through judicial sentences. An analysis was developed about
the position of the Federal Supreme Court in relation to the judicialization of health, since,
over the years, an understanding regarding this problem was being conceived, divided into
four distinct phases. Finally, an explanation was given regarding the factual reality found in
the Municipality of Picos, with reference to the judicialization of health, analyzing the
continuous expenses generated by the judicialization; the passive pole of lawsuits; and the
admission profile of the users. An approach about the main proposals to alleviate the conflicts arising from the judicialization of health was developed, which listed seven actions, namely: the Health Technology Assessment - HTA; renewal of the medical prescription; technical notes from the Technical Support Centers of the Judiciary (TSCJ) and expert reports; health evidence analysis; consequentialism; health outcomes; value-based health; and rejection of the judicialization of predatory health. It has reached the conclusion of the necessity to build a new scenario in Brazil, which, in addition to the legal possibilities already mentioned, can also be considered what is called "the lessening of health jurisdiction", which seeks to resolve conflicts through administrative and extrajudicial means. That said, this dissertation will propose to the health authorities of the Municipality of Picos the foundation of an Interinstitutional Committee for the Resolution of Administrative Health Claims, which will play the role of mediating body in the disputes still in the administrative sphere and will also play the role of monitoring the results and consequences of decisions handed down in court.
Keywords: sanitary judicialization; public policy; federal supreme court; consequentialism;
municipality health committee. Ver menos
regarding the right to health. The recognition and protection of health law expose a legal good
of common nature, which is reflected in the individual sphere, generating a higher need for
both subjective and... Ver mais The enactment of the 1988 Federal Constitution inaugurated a new scenario in Brazil
regarding the right to health. The recognition and protection of health law expose a legal good
of common nature, which is reflected in the individual sphere, generating a higher need for
both subjective and objective protection. Contrary to what was posited in the Major Law, it
was possible to verify a crisis in the financing of SUS, which generated what is called
"defunding", weakening the application of public health policies and boosting the
phenomenon of judicialization, which is the core of the present dissertation, whose field of
research and data collection was the Municipality of Picos, with a time frame between the
years 2012 and 2020. The central question of the study carried out was: are there continuous
expenses with medicines and supplies by court order? The other two issues raised concern
about the volume of processes and the effective impacts of these decisions on public policies
in the Municipality of Picos. It was found that judicialization can cause instability and
imbalance in the State, considering that the access to health services must be implemented
through public policy and not through judicial sentences. An analysis was developed about
the position of the Federal Supreme Court in relation to the judicialization of health, since,
over the years, an understanding regarding this problem was being conceived, divided into
four distinct phases. Finally, an explanation was given regarding the factual reality found in
the Municipality of Picos, with reference to the judicialization of health, analyzing the
continuous expenses generated by the judicialization; the passive pole of lawsuits; and the
admission profile of the users. An approach about the main proposals to alleviate the conflicts arising from the judicialization of health was developed, which listed seven actions, namely: the Health Technology Assessment - HTA; renewal of the medical prescription; technical notes from the Technical Support Centers of the Judiciary (TSCJ) and expert reports; health evidence analysis; consequentialism; health outcomes; value-based health; and rejection of the judicialization of predatory health. It has reached the conclusion of the necessity to build a new scenario in Brazil, which, in addition to the legal possibilities already mentioned, can also be considered what is called "the lessening of health jurisdiction", which seeks to resolve conflicts through administrative and extrajudicial means. That said, this dissertation will propose to the health authorities of the Municipality of Picos the foundation of an Interinstitutional Committee for the Resolution of Administrative Health Claims, which will play the role of mediating body in the disputes still in the administrative sphere and will also play the role of monitoring the results and consequences of decisions handed down in court.
Keywords: sanitary judicialization; public policy; federal supreme court; consequentialism;
municipality health committee. Ver menos
Dias, Eduardo Rocha
Orientador
Leitão, Rômulo Guilherme
Banca examinadora
Leitão, André Studart
Banca examinadora
Universidade de Fortaleza. Programa de Pós-Graduação em Direito Constitucional
Dissertação (mestrado)