Judicialização da saúde em Paraíba do Sul: um estudo das políticas públicas de saúde no município dos anos de 2018 a 2023

Abstract

This research aimed to investigate health-related lawsuits filed in Paraíba do Sul between 2018 and 2023 and to compare them with the municipality's health budget during the same period, with the objective of verifying whether the fulfillment of the social right to health through public policies is more effective. To that end, the following data were collected from the lawsuits: the cost of the health claim, the total cost of the legal proceeding, the age and gender of the claimants, the types of requests made, the essentiality of the demand, and the legal representation involved. As the period analyzed included the two main years of the Covid-19 health crisis, the study also allowed for inferences—based on the two years preceding and following the pandemic—about the impacts of the pandemic on health-related litigation in the municipality. The data collection from lawsuits characterized this as empirical research, based on direct sources and conducted through the inductive method, since general conclusions were drawn from the individual analysis of cases. Additionally, a literature review was conducted to establish the theoretical framework—namely, the Theory of Fundamental Rights—which allowed for the characterization of the fundamental right to health as a principle-norm and clarified how to rationally resolve potential conflicts between the right to health and other principles through the balancing technique. To provide a deeper understanding of the phenomenon of health judicialization in Brazil, the study presented key precedents from the country’s higher courts, offering an overview of the resulting advancements and setbacks. Subsequently, the empirical data collected were analyzed, and conclusions were drawn through the application of inferential techniques. It was found that, although judicialization is a legitimate means to guarantee access to health services when they are insufficient or unavailable through administrative channels, strengthening public health policies enables a more universal and cost-effective realization of this right and should be prioritized. Additional findings included that most lawsuits were sponsored by the Public Defender’s Office, indicating that most claimants are economically disadvantaged. Moreover, most claimants were elderly individuals, highlighting the inadequacy of public policies aimed at elderly healthcare. The pandemic was found to have had little impact on health-related litigation in the municipality, possibly due to the suspension of in-person services at the Public Defender’s Office during that period. The limited number of claims directly related to the health crisis may also be attributed to improvements in healthcare infrastructure implemented during the pandemic.