Investimento em Saúde Pública e Judicialização no Brasil: uma análise do período da pandemia de Covid-19

Abstract

This research aimed to investigate the relationship between public health investment and the increase in the judicialization of health in Brazil during the Covid-19 pandemic. The initial hypothesis suggested that the exacerbation of chronic underfunding of the Brazilian public health system could explain the significant increase in the judicialization of health during the Covid-19 pandemic, as evidenced by the number of initiated cases: 208,070 in 2020 and 247,110 in 2021, compared to 37,257 in 2019 (Brazil, 2023a). The objective was to demonstrate a cause-and-effect relationship between the decrease in administrative investment in public health and the observed increase in the judicialization of health during the Covid-19 sanitary crisis. The research adopted a descriptive, exploratory, and propositional approach, utilizing deductive methods for both qualitative and quantitative research. Initially, a literature review on the judicialization of health and the Theory of Fundamental Rights (Alexy, 2015) was conducted. Subsequently, data collection on the judicialization of health in Brazil during the pandemic was carried out using the National Council of Justice (Brazil, 2023a) records to demonstrate the growth of the phenomenon during the health crisis. Following this, a brief historical retrospective on the judicialization of health and public health investment in Brazil from 2014 to 2020 was presented. Afterward, an international comparative analysis was undertaken to examine Brazil's health investments compared to the global average during the pandemic. This sample covered 56 countries, including all OECD members and the 50 most populous, with data obtained from the WHO (Switzerland, 2023). Missing data for Brazil in 2021 were supplemented with information from the Transparency Portal (Brazil, 2023b). The results were visually presented in graphs, revealing a substantial increase in the judicialization of health in Brazil during the pandemic. However, when comparing health investment to GDP, it was found that Brazil remained in line with the global average. Therefore, the results indicated that the increase in the judicialization of health during the pandemic cannot be directly attributed to a deepening of underfunding in the country's public health, despite recognizing it as a cause for ordinary citizens to seek judicial intervention to enforce their right to health.