The Growing Role of SUS in Providing Health Rights

In 2025, the Brazilian Unified Health System (SUS) remains one of the largest and most ambitious public health systems in the world, offering universal healthcare to over 200 million citizens. The government continues to make efforts to improve healthcare services, ensuring access for all, regardless of income, race, or geographical location. One of the most significant steps in this process is the legal inclusion of humanized care as a guiding principle of SUS, as established in Law No. 15.126, signed in April 2025. This law emphasizes the provision of healthcare services that are not only effective but also compassionate, with a focus on patient dignity and respect for individual needs.

While these efforts represent progress, there are numerous ongoing challenges in ensuring that all citizens can truly benefit from the services provided by SUS, especially in the face of increasing demand for healthcare services, a growing aging population, and financial constraints.

The Challenge of Healthcare Judicialization

Healthcare judicialization refers to the increasing number of legal cases filed by citizens who seek to obtain medical treatments and medications that are not readily available through the SUS. As of 2025, nearly 870,000 lawsuits are in progress in Brazil, with many of them related to healthcare issues. These cases often involve people seeking access to expensive drugs, specialized treatments, or surgeries that the public healthcare system cannot provide quickly enough.

Key Factors Contributing to Judicialization:

1. Delays in SUS Services: The main reason people turn to the judiciary is the long wait times for treatments, medications, or surgeries. Patients often seek to bypass bureaucratic processes through court orders, leading to a rise in judicial claims.

2. Lack of Availability of Specific Treatments: While SUS provides a broad range of treatments, the system is often unable to offer specialized or experimental treatments that may be vital to patients’ survival or well-being. This leads many to file lawsuits to obtain these treatments through private providers or to gain access to government programs.

3. Overloaded Judicial System: The volume of healthcare-related lawsuits puts immense pressure on Brazil’s judicial system. Many judges are forced to make quick decisions without proper technical or medical expertise, which could lead to unintended consequences, such as prioritizing individuals based on their ability to litigate, rather than on medical need.

Legal Responses to Healthcare Judicialization

The Brazilian government has acknowledged the problem of judicialization and is exploring various avenues to reduce the burden on the judiciary while ensuring citizens still have access to essential health services. Several proposals are being considered to mitigate the issue, including:

1. Strengthening the Administrative Process: One of the most promising solutions is strengthening the administrative mechanisms within SUS. If patients are better able to navigate the system and resolve issues without resorting to the courts, this would reduce the number of lawsuits. Increased transparency and clearer guidelines for service delivery are critical to this process.

2. Integration of the Judicial and Executive Branches: Another potential solution is better integration between the judicial and executive branches of government. Some suggest that judicial rulings should work in tandem with SUS policies to ensure fairness and equal access to healthcare services. Collaborative efforts between the Ministry of Health, the judiciary, and legal experts could help streamline access to necessary treatments.

3. Establishment of Health Courts: In an effort to reduce the strain on regular courts, there has been ongoing discussion about establishing specialized health courts. These courts would have experts in healthcare law and policy, allowing for more informed decisions and ensuring that patients receive the best possible treatment without the delays associated with traditional court cases.

Advances in Humanized Care and Quality of Life

In addition to addressing judicialization, Brazil has taken major strides in improving the quality of care within SUS. The humanization of healthcare is a central theme of the 2025 reforms, with a focus on making medical services more empathetic and patient-centered. Efforts include:

1. Patient-Centered Healthcare Models: The adoption of care models that emphasize communication between healthcare providers and patients, ensuring that patients are more involved in decisions about their care.

2. Mental Health Services: A significant increase in the availability and funding of mental health services, recognizing the growing importance of addressing mental health issues alongside physical health concerns.

3. Telemedicine and Digital Health: The expansion of telemedicine services to remote areas is making healthcare more accessible to people who previously had to travel long distances to see a doctor. This has been especially crucial in rural and underserved areas where healthcare infrastructure is limited.

4. Better Support for Health Workers: The government is working to ensure that healthcare professionals receive better training and support to offer more compassionate, patient-centered care. Initiatives include professional development programs, increased wages, and initiatives to prevent burnout among health workers.

The Future of Health Rights in Brazil

While there have been significant advancements in Brazil’s healthcare system, the challenges persist. For legal professionals and healthcare providers, it is crucial to stay up to date on the evolving landscape of healthcare rights in Brazil. With ongoing legislative changes, the inclusion of humanized care principles in the public health sector, and continued efforts to address judicialization, there is hope that Brazil will create a more equitable and accessible healthcare system for all its citizens in the years to come.

Legal experts must focus on strengthening the relationship between the judicial and administrative systems and ensuring that healthcare access remains a fundamental right. With the right reforms, Brazil could pave the way for a model of public health that is not only efficient but also humane and responsive to the needs of all its people.