A proposed amendment to the Constitution (PEC) presented by Senator Marcelo Castro (MDB-PI) seeks to “de-judicialize Health”. According to the text of the proposal, the Unified Health System (SUS) can only provide medicines and procedures that have been formally incorporated through technical analysis.
PEC 45/2021 modifies article 198 of the Constitution, making it explicit that the incorporation of medicines, products and procedures by the SUS will be done “by prior analysis by a national body”. In addition, it determines that the technologies to be offered by the SUS will be limited to the official lists of medicines, actions and health services.
In the justification of the PEC, Marcelo Castro argues that the constitutional guideline of comprehensive health care requires “mechanisms that can better define its limits”, since it is not “feasible to grant everyone everything that is intended”. For this, there are the official listings of the National List of Essential Medicines (Rename) and the National List of Health Actions and Services (Renases). In addition, according to the current law, new health technologies must be examined by the National Commission for the Incorporation of Health Technologies (Conitec).
However, according to the parliamentarian, the current legislation does not impose clear limits on the demand for treatments. The text also emphasizes that “in universal health systems, the list of medicines and procedures is always binding on the health professional”. As a result, several patients turn to the Judiciary to guarantee the free supply, by SUS, of medicines and therapies not available in the public network, many of them with very high costs.
“It is possible to verify, due to the intense judicialization in our country, the attempt to transform the Judiciary into a gateway to the Unified Health System, which generates serious distortions. There are around half a million lawsuits in the health area, according to data from the National Council of Justice”, laments the senator.
In this sense, Marcelo Castro cites the experience of universal health systems in other countries, which are governed by organizing norms that impose limits on the system “by defining a list of health services that, before their incorporation, are subject to technical-scientific, cost-benefit and effectiveness analysis in relation to other technologies”.
Agência Senado (Reproduction authorized with reference to Agência Senado)