Operationalization of the Brazilian National Health System and its pharmacy assistance in face of judicialization: a case study in the Municipality of São José, State of Santa Catarina

Abstract

The present study based on the premise that the Judiciary Branch has enforced the right to health without observance to the public policies of the sector and the identification of negative effects of this judicialization on the operationalization of the Brazilian National Health System and its pharmacy assistance. It attempts to find out in what ways these negative effects are exposed in the decision through which the Municipality of São José (State of Santa Catarina) was forced to supply medicines. To deal with this problem, decisions were selected among those enacted from 09/01/2013 to 08/31/2015 by the Court of Justice of Santa Catarina by means of collective and monocratic court rulings, in response to civil appeals filed by the Municipality of São José. Firstly, it is necessary to explain the relationship between the fundamental right to health and the system of operationalization of the Brazilian National Health System and its pharmacy service, including the circumstances of the municipality studied. Further on, the positive and negative effects of judicialization on this operationalization were systematized to verify ‒once confirmed the premise of the non-application of the public policies of the area– how those effects mirrored the decisions examined. At the end, it was possible to identify and point out how these negative effects were reflected in the court decisions, confirming a scenario in which judicial action contributes to disorganize and disrupt the Brazilian National Health System, and made evident the need for judiciary actions to be carried out in a way to allow the system to work as a public national health system.