Agenda única de saúde: a busca do acesso universal e a garantia do direito à saúde

• Autor(a) principal: Bomfim, Regina Lúcia Dodds
• Data de Publicação: 2008
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/4596
• topic: Universal acess; Health right; Right guarantee; Health technology incorporations; The lawing of health; Acesso universal; Direito à saúde; Garantia de direito; Incorporação de tecnologias de saúde; Judicialização de saúde; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA

The objective of this study is to identify the increase of the judicial demands against the managers of SUS (Unified Health System). Most of them (85%) are related with medicines supply and generated by Judiciary beliefs that the Government is not serving the right to health constitutionally acquired. A bibliographical revision concerning national systems of health with basic principles similar to SUS was made. The countries selected were Canada, Colombia and Spain. The objective was to observe if the difficulties experienced by SUS exists in those systems or if it is a brazilian peculiarity. The articles of 1988 Brazilian Magna Law related to Health were analyzed and it was possible to observe that, in many of them, there is not a clear definition of concepts, allowing multiple interpretations from the party involved in SUS implementation. A qualitative and quantitative research was developed: the first component was carried through by interviews with key representants from the Executive, Legislative, Judiciary, Professional Classes, Health Consil and Managers. The quantitative stage was carried through collection, systematization and analysis of data concerning the judicial processes against the managers of SUS located in Rio de Janeiro (SMS, SESDEC and NERJ). The understandings of interviewed people are very diverse and related to their working area. It was observed that the Judiciary ratifies the medical prescriptions, determining managers to supply health products, essential medicines or the ones of exceptionally use, even imported substances. The judicial decisions do not attend the standard of Pharmaceutical Assistance Politics definitions, nor the ones about the relations agreed between the managers, nor the management level responsibility. Such problems are causing a permanent tension between Health Executive, Judiciary and population, once the compliance of judicial decisions represents the budget replacement to purchase a not planned medicine, which can represent not accomplishing priority actions. It seems that these judicial decisions, despite its legitimate, do not help the equal access to SUS. Finally, it was defined 3 causes to the increase of the judicial health demands: 1st is born from the poor clarity of some constitutional concepts, determinated by the lack of political agreements among parliament members at the ANC, living for posterior definition, never achieved; 2nd not represented by the plea of the biggest medical lapsing but by the Judiciary, seemingly to demonstrate the power of every profession (medical and judiciary) and inexistence of regulations as, for instance, happens in the Canadian system; 3rd the lack of links in the SUS between the financial management and care for health itself. It seems to hind the managers actions as protagonists of such situations.