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Courts and health care rationing: the case of the Brazilian Federal Supreme Court

Published online by Cambridge University Press:  08 October 2012

Daniel W. L. Wang
Daniel W. L. Wang*
Affiliation:
PhD Candidate at the London School of Economics and Political Science, London, UK
*
*Correspondence to: Daniel W. L. Wang, PhD Candidate at the London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK. Email: d.w.wang@lse.ac.uk
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Abstract

The recognition that access to health care is a constitutional right in Brazil has resulted in a situation in which citizens denied treatments by the public health care system have brought lawsuits against health authorities, claiming that their right to health was violated. This litigation forces the courts to decide between a patient-centred and a population-centred approach to public health – a choice that forces the courts to assess health care rationing decisions. This article analyses the judgments of the Brazilian Federal Supreme Court in right to health cases, arguing that the Court's recent decisions have been contrary to their long-standing stance against rationing. In 2009, the Court organized a public hearing to discuss this topic with civil society and established criteria to determine when rationing would be legal. However, I argue that these criteria for health care rationing do not adequately address the most difficult health care distribution dilemmas. They force the health care system to keep their rationing criteria implicit and make population-centred concerns secondary to individual-centred ones.

Type
Articles
Information
Health Economics, Policy and Law , Volume 8 , Issue 1 , January 2013 , pp. 75 - 93
Copyright
Copyright © Cambridge University Press 2012

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