Judicialization of supplementary health: The construction of the recent understanding regarding the exceptional exhaustive nature of the list of procedures and the impossibility of economic analysis of essential social rights

Detalhes bibliográficos
Autor(a) principal: Martins, Fabrício Irun Silveira
Data de Publicação: 2022
Tipo de documento: Artigo
Idioma: por
Título da fonte: Revista da EMERJ (Online)
Texto Completo: https://ojs.emerj.com.br/index.php/revistadaemerj/article/view/405
Resumo: The Brazilian Superior Court of Justice records conflicting, despite recently conciliated, interpretations on the matter of health care plans, regarding their coverage to be based on a strict or a non-comprehensive catalog of procedures. In the first case, the arguments are inspired by the grounds of the theory known as the Economic Analysis of Law. In contrast, the systematic application of consumer law prevails. The present study develops each of the referred lines of reasoning and, by honoring the viewpoint that contemplates the non-itemized list of health procedures, adds new reflections on the subject not only from the interpretation of the pertaining legal provisions but also concerning the legality control of Resolution nº 465/21 and the decision-making parameters on the theme.
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spelling Judicialization of supplementary health: The construction of the recent understanding regarding the exceptional exhaustive nature of the list of procedures and the impossibility of economic analysis of essential social rightsJudicialização da saúde suplementar: A construção do recente entendimento acerca do caráter taxativo excepcionável do rol de procedimentos e a impossibilidade de análise econômica de direitos sociais essenciaisplanos de saúderol de procedimentosanálise econômica do direitodireitos sociaishealth care planscatalog of procedureseconomic analysis of lawsocial rightsThe Brazilian Superior Court of Justice records conflicting, despite recently conciliated, interpretations on the matter of health care plans, regarding their coverage to be based on a strict or a non-comprehensive catalog of procedures. In the first case, the arguments are inspired by the grounds of the theory known as the Economic Analysis of Law. In contrast, the systematic application of consumer law prevails. The present study develops each of the referred lines of reasoning and, by honoring the viewpoint that contemplates the non-itemized list of health procedures, adds new reflections on the subject not only from the interpretation of the pertaining legal provisions but also concerning the legality control of Resolution nº 465/21 and the decision-making parameters on the theme.O Superior Tribunal de Justiça registra conflito de entendimentos no âmbito da Terceira e Quarta Turmas relativamente à natureza taxativa ou exemplificativa do rol de procedimentos que orienta o exercício da atividade dos planos de saúde, recentemente pacificado em julgamento conduzido pela Segunda Seção da Corte. No primeiro caso, colhem-se argumentos inspirados nas bases da teoria da Análise Econômica do Direito. Na outra via, prepondera a aplicação sistemática de normas de natureza consumerista. O presente estudo desenvolve cada uma dessas linhas de pensamento e, prestigiando o acerto da tese segundo a qual o rol de coberturas contratuais deveria ser considerado exemplificativo, acresce reflexões na matéria a partir da interpretação dos dispositivos legais de regência, da realização de controle de legalidade da Resolução n. 465/21 e da abordagem das premissas decisórias constantes do julgado que uniformizou o entendimento no tema.Escola da Magistratura do Estado do Rio de Janeiro2022-01-26info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://ojs.emerj.com.br/index.php/revistadaemerj/article/view/405Revista da EMERJ; v. 24 n. 2 (2022): Revista da EMERJ; 87-1192236-89571415-4951reponame:Revista da EMERJ (Online)instname:Escola da Magistratura do Estado do Rio de Janeiro (EMERJ)instacron:EMERJporhttps://ojs.emerj.com.br/index.php/revistadaemerj/article/view/405/187Copyright (c) 2022 Revista da EMERJhttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessMartins, Fabrício Irun Silveira2023-12-11T18:36:51Zoai:ojs2.emerj.jus.br:article/405Revistahttps://ojs.emerj.com.br/index.php/revistadaemerj/indexPUBhttps://ojs.emerj.com.br/index.php/revistadaemerj/oairevistadaemerj@tjrj.jus.br2236-89571415-4951opendoar:2023-12-11T18:36:51Revista da EMERJ (Online) - Escola da Magistratura do Estado do Rio de Janeiro (EMERJ)false
dc.title.none.fl_str_mv Judicialization of supplementary health: The construction of the recent understanding regarding the exceptional exhaustive nature of the list of procedures and the impossibility of economic analysis of essential social rights
Judicialização da saúde suplementar: A construção do recente entendimento acerca do caráter taxativo excepcionável do rol de procedimentos e a impossibilidade de análise econômica de direitos sociais essenciais
title Judicialization of supplementary health: The construction of the recent understanding regarding the exceptional exhaustive nature of the list of procedures and the impossibility of economic analysis of essential social rights
spellingShingle Judicialization of supplementary health: The construction of the recent understanding regarding the exceptional exhaustive nature of the list of procedures and the impossibility of economic analysis of essential social rights
Martins, Fabrício Irun Silveira
planos de saúde
rol de procedimentos
análise econômica do direito
direitos sociais
health care plans
catalog of procedures
economic analysis of law
social rights
title_short Judicialization of supplementary health: The construction of the recent understanding regarding the exceptional exhaustive nature of the list of procedures and the impossibility of economic analysis of essential social rights
title_full Judicialization of supplementary health: The construction of the recent understanding regarding the exceptional exhaustive nature of the list of procedures and the impossibility of economic analysis of essential social rights
title_fullStr Judicialization of supplementary health: The construction of the recent understanding regarding the exceptional exhaustive nature of the list of procedures and the impossibility of economic analysis of essential social rights
title_full_unstemmed Judicialization of supplementary health: The construction of the recent understanding regarding the exceptional exhaustive nature of the list of procedures and the impossibility of economic analysis of essential social rights
title_sort Judicialization of supplementary health: The construction of the recent understanding regarding the exceptional exhaustive nature of the list of procedures and the impossibility of economic analysis of essential social rights
author Martins, Fabrício Irun Silveira
author_facet Martins, Fabrício Irun Silveira
author_role author
dc.contributor.author.fl_str_mv Martins, Fabrício Irun Silveira
dc.subject.por.fl_str_mv planos de saúde
rol de procedimentos
análise econômica do direito
direitos sociais
health care plans
catalog of procedures
economic analysis of law
social rights
topic planos de saúde
rol de procedimentos
análise econômica do direito
direitos sociais
health care plans
catalog of procedures
economic analysis of law
social rights
description The Brazilian Superior Court of Justice records conflicting, despite recently conciliated, interpretations on the matter of health care plans, regarding their coverage to be based on a strict or a non-comprehensive catalog of procedures. In the first case, the arguments are inspired by the grounds of the theory known as the Economic Analysis of Law. In contrast, the systematic application of consumer law prevails. The present study develops each of the referred lines of reasoning and, by honoring the viewpoint that contemplates the non-itemized list of health procedures, adds new reflections on the subject not only from the interpretation of the pertaining legal provisions but also concerning the legality control of Resolution nº 465/21 and the decision-making parameters on the theme.
publishDate 2022
dc.date.none.fl_str_mv 2022-01-26
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://ojs.emerj.com.br/index.php/revistadaemerj/article/view/405
url https://ojs.emerj.com.br/index.php/revistadaemerj/article/view/405
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://ojs.emerj.com.br/index.php/revistadaemerj/article/view/405/187
dc.rights.driver.fl_str_mv Copyright (c) 2022 Revista da EMERJ
https://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2022 Revista da EMERJ
https://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Escola da Magistratura do Estado do Rio de Janeiro
publisher.none.fl_str_mv Escola da Magistratura do Estado do Rio de Janeiro
dc.source.none.fl_str_mv Revista da EMERJ; v. 24 n. 2 (2022): Revista da EMERJ; 87-119
2236-8957
1415-4951
reponame:Revista da EMERJ (Online)
instname:Escola da Magistratura do Estado do Rio de Janeiro (EMERJ)
instacron:EMERJ
instname_str Escola da Magistratura do Estado do Rio de Janeiro (EMERJ)
instacron_str EMERJ
institution EMERJ
reponame_str Revista da EMERJ (Online)
collection Revista da EMERJ (Online)
repository.name.fl_str_mv Revista da EMERJ (Online) - Escola da Magistratura do Estado do Rio de Janeiro (EMERJ)
repository.mail.fl_str_mv revistadaemerj@tjrj.jus.br
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