Judicialização no SUS: Justiça Social ou Desequilíbrio?

Uma revisão narrativa com foco em OPME e Regulação Assistencial

Abstract

What should be done when public health policies fail to satisfactorily meet the needs of citizens? Is judicialization the viable alternative? This study aims to analyze the right to health in light of current legislation, focusing on the judicialization of health within the scope of the Unified Health System (SUS), with an emphasis on processes related to healthcare regulation and Orthoses, Prostheses, and Special Materials (OPME). This research consists of a narrative literature review with a qualitative approach. The search tool utilized was Google Scholar, through which national articles available in full text and published between 2010 and 2025 were selected, complemented by institutional documents relevant to the contextualization of the theme. The choice of this tool is justified by Google Scholar’s ability to identify published works indexed across diverse repositories, covering a broader spectrum of sources such as open-access articles, theses, dissertations, and publications in non-indexed journals. The guiding question investigates whether the judicialization of health represents a mechanism for achieving social justice or if it acts as a factor of imbalance for the SUS. The analysis identified fourteen relevant articles: eleven centered on healthcare regulation and three focused on the theme of OPME, with special attention to the institutional roles of the National Council of Justice (CNJ), the Federal Court of Accounts (TCU), and the Supreme Federal Court (STF). The study concludes that while judicialization represents a legitimate pathway for guaranteeing rights, its excessive use has resulted in negative impacts, such as budgetary imbalances, the disorganization of the SUS, and increased inequalities. Furthermore, it should not be interpreted simplistically as either an isolated solution or a problem, but rather as an expression of the need for institutional improvement. As a strategic measure, the creation of a National System for the Judicialization of Health is proposed, aiming to promote transparency, strengthen social control, and support the formulation of fairer, evidence-based public policies.

Keywords: Judicialization of health. Right to health. Unified Health System (SUS). OPME. Regulation.