TY - JOUR
T1 - The judicialization of health and the quest for state accountability
T2 - Evidence from 1,262 lawsuits for access to medicines in southern Brazil
AU - Biehl, João
AU - Socal, Mariana P.
AU - Amon, Joseph J.
N1 - Publisher Copyright:
© 2016 Biehl, Socal, and Amon.
PY - 2016/6
Y1 - 2016/6
N2 - The impact of increasing numbers of lawsuits for access to medicines in Brazil is hotly debated. Government officials and scholars assert that the “judicialization of health” is driven by urban elites and private interests, and is used primarily to access high-cost drugs. Using a systematic sample of 1,262 lawsuits for access to medicines filed against the southern Brazilian state of Rio Grande do Sul, we assess these claims, offering empirical evidence that counters prevailing myths and affirms the heterogeneity of the judicialization phenomenon. Our findings show that the majority of patient-litigants are in fact poor and older individuals who do not live in major metropolitan areas and who depend on the state to provide their legal representation, and that the majority of medicines requested were already on governmental formularies. Our data challenge arguments that judicialization expands inequities and weakens the universal health care system. Our data also suggest that judicialization may serve as a grassroots instrument for the poor to hold the state accountable. Failing to acknowledge regional differences and attempting to fit all data into one singular narrative may be contributing to a biased interpretation of the nature of judicialization, and limiting the understanding of its drivers, consequences, and implications at local levels.
AB - The impact of increasing numbers of lawsuits for access to medicines in Brazil is hotly debated. Government officials and scholars assert that the “judicialization of health” is driven by urban elites and private interests, and is used primarily to access high-cost drugs. Using a systematic sample of 1,262 lawsuits for access to medicines filed against the southern Brazilian state of Rio Grande do Sul, we assess these claims, offering empirical evidence that counters prevailing myths and affirms the heterogeneity of the judicialization phenomenon. Our findings show that the majority of patient-litigants are in fact poor and older individuals who do not live in major metropolitan areas and who depend on the state to provide their legal representation, and that the majority of medicines requested were already on governmental formularies. Our data challenge arguments that judicialization expands inequities and weakens the universal health care system. Our data also suggest that judicialization may serve as a grassroots instrument for the poor to hold the state accountable. Failing to acknowledge regional differences and attempting to fit all data into one singular narrative may be contributing to a biased interpretation of the nature of judicialization, and limiting the understanding of its drivers, consequences, and implications at local levels.
UR - http://www.scopus.com/inward/record.url?scp=84975318282&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84975318282&partnerID=8YFLogxK
M3 - Article
C2 - 27781011
AN - SCOPUS:84975318282
VL - 18
SP - 209
EP - 220
JO - Health and Human Rights
JF - Health and Human Rights
SN - 1079-0969
IS - 1
ER -