A implementação do direito à saúde como fator de desenvolvimento humano e o princípio da reserva do possível
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Data
2018-09-14
Autores
Melo, Amanda Caroline Mantovani
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Universidade Estadual Paulista (Unesp)
Resumo
O direito à saúde é um dos principais instrumentos de garantia do direito à dignidade humana e do direito à vida. Por meio da garantia à saúde é que se torna possível atingir um determinado nível de desenvolvimento – chamado desenvolvimento humano – que é resultado do estímulo a que o homem atinja o patamar de ideal de sua liberdade. O desenvolvimento humano atingido por meio da garantia do direito à saúde efetivo tem por resultado influenciar no desenvolvimento pessoal para que cada indivíduo encontre e desenvolva suas vocações profissionais e pessoais, para que se permita aos cidadãos viverem em função da satisfação promovida por suas escolhas, para que suas atividades profissionais ou pessoais não sejam fruto de circunstâncias externas que tolheram oportunidades e alteraram seus destinos, como a fome, a doença ou o analfabetismo. Evidentemente, há inúmeros fatores que provocam essa consequência e esta pesquisa foi delimitada unicamente ao fator “saúde”. Considerando que a Constituição Federal dispõe que “A saúde é direito de todos e dever do Estado” (art. 196) e que muitas vezes esse direito é olvidado pelo próprio prestador, torna-se necessário que o usuário do sistema público de saúde se utilize de meios coercitivos para que seu direito seja cumprido. É traçada a primeira premissa: sendo direito de todos, apenas terá garantida a saúde aquele que tiver acesso ao Poder Judiciário. Disto, decorrem as críticas tecidas pelo próprio Poder Judiciário, a respeito da utilização excessiva de pleitos judiciais com o escopo de compelir o Poder Executivo ao cumprimento da Constituição: a judicialização da saúde, o ativismo judicial e a ingerência entre Poderes. A premissa seguinte a ser abordada refere-se a uma das principais teses de defesa apresentada pelo Poder Público: o postulado da reserva do economicamente possível, que perpassa pelas análises dos conceitos entre princípio e norma, do princípio da proporcionalidade, princípio da razoabilidade e, por derradeiro, sobre o princípio da proibição do retrocesso social, que obstaria – ao menos inicialmente – a invocaçãodo postulado da reserva do economicamente possível para evitar condenações em ações de obrigação de fazer com o objeto “saúde”, pois representaria nítido regresso social vedado pela Constituição Federal. Por derradeiro, considerando que a questão do direito à saúde abarca também a questão do custo que a garantia desse direito representa ao erário, foi necessário abordar o tema da responsabilidade fiscal, com o fim de responder à indagação sobre se garantia do direito à saúde, da maneira como se tem visto ser noticiada, seria ineficaz por falta das respectivas verbas ou pelo excesso burocrático traçado pela Lei de Responsabilidade Fiscal, que, ao pretender proteger o erário provocaria, em contrapartida, a dificuldade no repasse dos respectivos valores. Onde estaria o real problema para tornar a saúde, efetivamente, um direito coletivamente garantido com qualidade e que teria por resultado o desenvolvimento humano dos cidadãos brasileiros? Para isso, foram utilizados os métodos analítico, dedutivo, e o empírico, dadas as pesquisas em dados estatísticos a permitir a análise da atual conjuntura verificada no campo da saúde pública, além do pensamento crítico analítico sobre o tema. Dada a estrutura de prospecção, foi possível observar que o excesso legislativo somado à ausência de controle de verificação orçamentário das políticas públicas da saúde constituem os principais fatores de descontrole público a culminar na falência do sistema de saúde; evidentemente, há outros fatores paralelos, como desvios orçamentários, falta de contratação de um número adequado de profissionais qualificados para prestarem serviços ao Sistema Único de Saúde, falta de promoção de políticas preventivas de saúde, entre outras, que, ainda que sanadas, não permitem a certeza de uma hipótese futura da plena efetivação do direito à saúde.Palavras-chave: Desenvolvimento humano. Direito à saúde. Judicialização de políticas públicas.
The right to health is one of the main instruments guaranteeing the right to human dignity and the right to life. Through the guarantee to health is that it becomes possible to reach a certain level of development - called human development - that is the result of the stimulus that man reaches the ideal level of his freedom. The human development achieved through the guarantee of the right to effective health has the effect of influencing personal development so that each individual finds and develops their professional and personal vocations so that citizens are allowed to live in function of the satisfaction promoted by their choices, that their professional or personal activities are not the result of external circumstances that have hindered opportunities and altered their destinies, such as hunger, disease or illiteracy. Obviously, there are many factors that cause this consequence and this research was limited only to the cause "health". Considering that the Federal Constitution states that "Health is the right of everyone and the duty of the State" (article 196) and that this right is often forgotten by the provider itself, it becomes necessary for the user of the public health system to use coercive means to ensure that their rights are fulfilled. That is the first premise: being everyone's right, only those who have access to the Judiciary may have its rigths. From this, the criticisms made by the Judiciary itself derive from the excessive use of judicial litigation with the scope of compelling the Executive Power to comply with the Constitution: judicialization of health, judicial activism and interference between Powers. The following premise to be addressed refers to one of the main theses of defense presented by the Public Power: the postulate of the reservation of the economically possible, which runs through the analysis of the concepts between principle and norm, the principle of proportionality, principle of reasonableness and, and finally, on the principle of the prohibition of social retrogression, which would prevent - at least initially - the invocation of the postulate of the reservation of the economically possible to avoid condemnation in actions of obligation to do with the object "health", since it would represent a clear forbidden social return by the Federal Constitution. Lastly, considering that the question of the right to health also covers the question of the cost of guaranteeing this right to the public, it was necessary to address the issue of fiscal responsibility in order to answer the question of whether the right to health is guaranteed, as it has been seen to be reported, would be ineffective due to lack of funds or due to the bureaucratic excess laid down by the Fiscal Responsibility Law, which, in attempting to protect the treasury, would, on the other hand, lead to difficulties in passing on their respective values. Where would be the real problem to make health effectively a collectively guaranteed right with quality and that would result in the human development of Brazilian citizens? For that, the analytical, deductive and empirical methods were used, given the statistical data to allow the analysis of the current situation in the field of public health, as well as analytical critical thinking on the subject. Given the prospecting structure, it was possible to observe that the legislative excess added to the lack of control of budgetary verification of the public health policies are the main factors of public uncontrolled to culminate in the bankruptcy of the health system; evidently, there are other parallel factors, such as budget deviations, lack of hiring of an adequate number of qualified professionals to provide services to the Unified Health System, lack of promotion of preventive health policies, among others, which, although remedied, do not allow the certainty of a future hypothesis of the full realization of the right to health.
The right to health is one of the main instruments guaranteeing the right to human dignity and the right to life. Through the guarantee to health is that it becomes possible to reach a certain level of development - called human development - that is the result of the stimulus that man reaches the ideal level of his freedom. The human development achieved through the guarantee of the right to effective health has the effect of influencing personal development so that each individual finds and develops their professional and personal vocations so that citizens are allowed to live in function of the satisfaction promoted by their choices, that their professional or personal activities are not the result of external circumstances that have hindered opportunities and altered their destinies, such as hunger, disease or illiteracy. Obviously, there are many factors that cause this consequence and this research was limited only to the cause "health". Considering that the Federal Constitution states that "Health is the right of everyone and the duty of the State" (article 196) and that this right is often forgotten by the provider itself, it becomes necessary for the user of the public health system to use coercive means to ensure that their rights are fulfilled. That is the first premise: being everyone's right, only those who have access to the Judiciary may have its rigths. From this, the criticisms made by the Judiciary itself derive from the excessive use of judicial litigation with the scope of compelling the Executive Power to comply with the Constitution: judicialization of health, judicial activism and interference between Powers. The following premise to be addressed refers to one of the main theses of defense presented by the Public Power: the postulate of the reservation of the economically possible, which runs through the analysis of the concepts between principle and norm, the principle of proportionality, principle of reasonableness and, and finally, on the principle of the prohibition of social retrogression, which would prevent - at least initially - the invocation of the postulate of the reservation of the economically possible to avoid condemnation in actions of obligation to do with the object "health", since it would represent a clear forbidden social return by the Federal Constitution. Lastly, considering that the question of the right to health also covers the question of the cost of guaranteeing this right to the public, it was necessary to address the issue of fiscal responsibility in order to answer the question of whether the right to health is guaranteed, as it has been seen to be reported, would be ineffective due to lack of funds or due to the bureaucratic excess laid down by the Fiscal Responsibility Law, which, in attempting to protect the treasury, would, on the other hand, lead to difficulties in passing on their respective values. Where would be the real problem to make health effectively a collectively guaranteed right with quality and that would result in the human development of Brazilian citizens? For that, the analytical, deductive and empirical methods were used, given the statistical data to allow the analysis of the current situation in the field of public health, as well as analytical critical thinking on the subject. Given the prospecting structure, it was possible to observe that the legislative excess added to the lack of control of budgetary verification of the public health policies are the main factors of public uncontrolled to culminate in the bankruptcy of the health system; evidently, there are other parallel factors, such as budget deviations, lack of hiring of an adequate number of qualified professionals to provide services to the Unified Health System, lack of promotion of preventive health policies, among others, which, although remedied, do not allow the certainty of a future hypothesis of the full realization of the right to health.
Descrição
Palavras-chave
Desenvolvimento humano, Direito à saúde, Judicialização de políticas públicas, Human development, Rigth to health, Juditialization of public policies