The impacts of health care judicialization in the city of Sao Paulo: Public expenditure and federal organization

Abstract

During the last years, the number of judicial decision ordering the provision of health treatments, equipment and surgeries by the public health system has increased. Judges tend to ignore their decisions’ budgetary impact and to consider that the Federal Government entities can be considered equally responsible by the supply of any item ordered by the patient. This paper analyzes the impact of these judicial decisions for the budgetary management of health policy in the City of Sao Paulo. It was considered an estimate with the expenses on the judicialization for the year of 2011, taking into consideration the data made available by the city and the publications in the official gazette about the acquisition of medications without bidding by the Municipal Health Department. According to the estimate of this article, the expenses of the city with health judicialization in 2011 is equivalent to 6% of the amount that the city spent with its policy of pharmaceutical assistance, and 10% of the total amount spent with the supply of medications, and hospital, dental and outpatient care material. Moreover, around 55% of the total amount is spent with drugs supply which are responsibility from the states and the union, and around 45% is spent with treatments that are not included in the Unified Public System (known as SUS).