Identificação do Impacto do Coronavírus na Judicialização da Saúde no Brasil
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2024-01-29
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Universidade Estadual Paulista (Unesp)
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Introdução: Desde a promulgação da Constituição Federal de 1988 e a conseguinte criação do Sistema Único de Saúde (SUS), conforme disposto em seu artigo 196, a saúde passou a ser vista como “um direito universal, e um dever do Estado”. A progressiva constitucionalização que os direitos sociais passaram na década de 1980, associada aos desafios de implementação efetiva por parte do Estado, fez que tais direitos fossem cada vez mais submetidos ao crivo das instituições jurídicas para sua efetivação. A judicialização da saúde brasileira, sempre foi uma dificuldade para os gestores públicos, visto que impacta diretamente na execução de políticas públicas de saúde. Considerando que a judicialização da saúde ocorre, para reivindicar qualquer questão que a envolva, surge a seguinte questão norteadora desse artigo como problema de pesquisa: a pandemia provocada pelo novo coronavírus repercutiu de alguma forma no já elevado número de judicialização da saúde existente no Brasil? Hipótese: Presume-se que a pandemia provocada pelo Coronavírus Covid-19 com redirecionamento dos recursos da saúde para o atendimento da emergência tenha aumentado o número de processos novos pleiteando alguma tecnologia de saúde no ano de 2020. Objetivo Geral: Identificar e comparar os números e o perfil referentes à Judicialização da saúde no Brasil nos anos de 2019 e 2020. Objetivos específicos: Identificar se houve um aumento no número de processos ajuizados no ramo da saúde no ano de 2020 decorrente da crise sanitária deflagrada pela da COVID-19. Comparar o número de novos processos ajuizados no ano de 2020 em relação à 2019 na área: “Direito da Saúde”, como também nos seus quatro temas: I) Doação e Transplante de órgãos, tecidos ou partes; II) Genética/células tronco; III) Saúde mental e IV) Saúde pública. Metodologia: Trata-se de uma pesquisa secundária, quantitativa, retrospectiva, que analisou os dados públicos oriundos do painel Justiça em Números produzido pelo Conselho Nacional de Justiça – CNJ. No presente trabalho foram analisados apenas os dados referentes a saúde pública, não tendo sido objeto de análise no presente estudo, portanto, os dados pertinentes à saúde suplementar. Os dados coletados e fornecidos pelo Conselho Nacional de Justiça são números absolutos e por isso, foi calculado a diferença em percentual referente ao aumento encontrado após a análise dos dados de 2019 e de 2020. Os dados são de domínio público e estão disponíveis no site https://www.cnj.jus.br/pesquisas-judiciarias/justica-em-numeros/. Resultados: observa-se que a judicialização do direito da saúde em 2020 representou um aumento de 459% em relação ao ano de 2019. O número de ações pleiteando saúde pública (que envolve fornecimento de insumos; fornecimento de medicamentos; internação/transferência hospitalar; sistema único de saúde; tratamento médico-hospitalar e vigilância sanitária e epidemiológica) apresentou um aumento de 391%, comparado com os dados do mesmo período de 2019. O fornecimento de medicamentos em geral (englobando todas as subclasses) foi 376% maior em 2020 se comparado a 2019. O fornecimento de medicamentos, quanto a subclasse, "sem registro na ANVISA", teve um aumento de 517% em 2020 em relação a 2019. O Sistema, nestes casos, é obrigado a arcar um serviço de saúde, mesmo sem ele estar inserido no âmbito das políticas e programas públicos executados pelo SUS, assim como, não estar previsto no Orçamento. Em relação a subclasse fornecimento de medicamentos, "registrados na ANVISA, mas não padronizados (também conhecido como off label)”, o aumento foi de 813%, comparando os dados de 2019 e 2020. As ações judiciais pleiteando internação/transferência hospitalar (englobando todas as subclasses) em 2020, representaram um aumento de 515% em relação aos dados de 2019. Conclusão: Com base nos dados obtidos neste estudo, concluiu-se que no primeiro ano da pandemia houve um aumento expressivo na judicialização da saúde em todas os temas, com maior expressão de processos no tema da “Saúde Pública”, certamente potencializado pelo colapso da assistência à saúde pelo redirecionamento dos recursos existentes ao atendimento da Covid-19.
Introduction: Since the promulgation of the Federal Constitution of 1988 and the subsequent creation of the Unified Health System (SUS), as determined in its article 196, health has come to be seen as “a universal right, and a duty of the State”. The progressive constitutionalization that social rights underwent in the 1980s, associated with the challenges of effective implementation by the State, meant that such rights were increasingly subjected to the scrutiny of legal institutions for their implementation. The judicialization of Brazilian health has always been a difficulty for public managers, as it directly impacts the execution of public health policies. Considering that the judicialization of health occurs, to claim any issue involving health, the following guiding question of this article arises as a research problem: has the pandemic caused by the new coronavirus had any impact on the already high number of judicialization of health in Brazil? Hypothesis: It is assumed that the pandemic caused by the Coronavirus has significantly increased the number of new processes requesting health technology in 2020. General Objective:Identify and compare the numbers and profile relating to the Judicialization of health in Brazil in the years 2019 and 2020. Specific objectives: To identify whether there was an increase in the number of lawsuits filed in the health sector in 2020 due to the health crisis caused by COVID-19. To compare the number of new lawsuits filed in 2020 in relation to 2019 in the area: "Health Law", as well as in its four themes: I) Donation and Transplantation of organs, tissues or parts;II) Genetics/stem cells; III) Mental health and IV) Public health. Methodology: Methodology: This is a secondary, quantitative, retrospective research that analyzed public data from the Justice in Numbers panel produced by the National Council of Justice – CNJ. In the present study, only the data related to public health were analyzed, and were not the object of analysis in the present study, therefore, the data pertinent to supplementary health. The data collected and provided by the National Council of Justice are absolute numbers and therefore it was calculated differently in percentage referring to the increase found after the analysis of data from 2019 and 2020. The data is in the public domain and is available on the website https://www.cnj.jus.br/pesquisas-judiciarias/justica-em-numeros/. Results: it is observed that the judicialization of health rights in 2020 represented an increase of 459% compared to 2019. The number of actions claiming public health (involving supply of inputs; supply of medicines; hospitalization/hospital transfer; single health system; medical-hospital treatment and sanitary and epidemiological surveillance) showed an increase of 391%, compared to data from the same period in 2019. The supply of medicines in general (encompassing all subclasses) was 376% higher in 2020 compared to 2019. The supply of medicine, regarding the subclass, "without registration with ANVISA", increased by 517% in 2020 compared to 2019. The System, in these cases, is obliged to pay for a health service, even without it being included within the scope of public policies and programs implemented by the SUS, as well as not being foreseen in the Budget. In relation to the drug supply subclass, "registered with ANVISA, but not standardized (also known as off label)", the increase was 813%, comparing data from 2019 and 2020. The legal actions requesting hospitalization/hospital transfer (encompassing all subclasses) in 2020, represented an increase of 515% in relation to 2019 data. Conclusion: Based on the data obtained in this study, it was concluded that in the first year of the pandemic there was a significant increase in the judicialization of health in all themes, with a greater expression of processes in the theme of "Public Health", certainly enhanced by the collapse of health care by the redirection of existing resources to Covid-19 care.
Introduction: Since the promulgation of the Federal Constitution of 1988 and the subsequent creation of the Unified Health System (SUS), as determined in its article 196, health has come to be seen as “a universal right, and a duty of the State”. The progressive constitutionalization that social rights underwent in the 1980s, associated with the challenges of effective implementation by the State, meant that such rights were increasingly subjected to the scrutiny of legal institutions for their implementation. The judicialization of Brazilian health has always been a difficulty for public managers, as it directly impacts the execution of public health policies. Considering that the judicialization of health occurs, to claim any issue involving health, the following guiding question of this article arises as a research problem: has the pandemic caused by the new coronavirus had any impact on the already high number of judicialization of health in Brazil? Hypothesis: It is assumed that the pandemic caused by the Coronavirus has significantly increased the number of new processes requesting health technology in 2020. General Objective:Identify and compare the numbers and profile relating to the Judicialization of health in Brazil in the years 2019 and 2020. Specific objectives: To identify whether there was an increase in the number of lawsuits filed in the health sector in 2020 due to the health crisis caused by COVID-19. To compare the number of new lawsuits filed in 2020 in relation to 2019 in the area: "Health Law", as well as in its four themes: I) Donation and Transplantation of organs, tissues or parts;II) Genetics/stem cells; III) Mental health and IV) Public health. Methodology: Methodology: This is a secondary, quantitative, retrospective research that analyzed public data from the Justice in Numbers panel produced by the National Council of Justice – CNJ. In the present study, only the data related to public health were analyzed, and were not the object of analysis in the present study, therefore, the data pertinent to supplementary health. The data collected and provided by the National Council of Justice are absolute numbers and therefore it was calculated differently in percentage referring to the increase found after the analysis of data from 2019 and 2020. The data is in the public domain and is available on the website https://www.cnj.jus.br/pesquisas-judiciarias/justica-em-numeros/. Results: it is observed that the judicialization of health rights in 2020 represented an increase of 459% compared to 2019. The number of actions claiming public health (involving supply of inputs; supply of medicines; hospitalization/hospital transfer; single health system; medical-hospital treatment and sanitary and epidemiological surveillance) showed an increase of 391%, compared to data from the same period in 2019. The supply of medicines in general (encompassing all subclasses) was 376% higher in 2020 compared to 2019. The supply of medicine, regarding the subclass, "without registration with ANVISA", increased by 517% in 2020 compared to 2019. The System, in these cases, is obliged to pay for a health service, even without it being included within the scope of public policies and programs implemented by the SUS, as well as not being foreseen in the Budget. In relation to the drug supply subclass, "registered with ANVISA, but not standardized (also known as off label)", the increase was 813%, comparing data from 2019 and 2020. The legal actions requesting hospitalization/hospital transfer (encompassing all subclasses) in 2020, represented an increase of 515% in relation to 2019 data. Conclusion: Based on the data obtained in this study, it was concluded that in the first year of the pandemic there was a significant increase in the judicialization of health in all themes, with a greater expression of processes in the theme of "Public Health", certainly enhanced by the collapse of health care by the redirection of existing resources to Covid-19 care.
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Saúde - Brasil, Judicialização da saúde, COVID-19 (Doença)