Judicial activism and the right to health: the judicialization that overruns management/Ativismo judicial e direito a saude: a judicializacao que atropela a gestao/Ativismo judicial y derecho a la salud: la judicializacion que atropella la gestion

The 1988 Federal Constitution defines the separation of powers, establishing limits and competencies for each one. However, in light of the alleged omission of the Executive and Legislative Powers in promoting public policies, society has turned to the Judiciary to ensure the enforcement of rights, particularly the right to health. This demand is supported by the principle of judicial protection. Under the argument that it is the Judiciary's duty to ensure the fulfillment of constitutional mandates, especially Article 196 of the Federal Constitution, the number of judicial decisions granting rights that should have been guaranteed by public policies has significantly increased. Among these decisions, the granting of medications through individual lawsuits stands out--the central focus of this study. However, the phenomenon of judicialization is not homogeneous and generates indirect effects that go beyond the right to health, including the emergency reallocation of resources, increased costs, and the deepening of social inequalities. A direct consequence of this practice is its negative impact on the public budget, as illustrated by cases involving the disease SMA and the treatment with Spinraza. Indirectly, judicialization imposes restrictions on other public policies prioritized by the original managers, to the detriment of the community as a whole. In this context, the present article seeks to better understand this situation and propose solutions that address social demands while preserving the equity and sustainability of the system. Keywords: Judicial Activism. Public Policy Control. Right to Health. Constitutional Rule of Law. Legitimacy and Limits. A Constituicao Federal de 1988 define a separacao dos poderes, estabelecendo limites e competencias de cada um. No entanto, diante da alegacao de omissao dos Poderes Executivo e Legislativo na promocao de politicas publicas, a sociedade passou a recorrer ao Poder Judiciario para assegurar a efetivacao de direitos, principalmente do direito a saude, fundamentando essa pretensao, com respaldo do Poder Judiciario, principalmente fundamentada na inafastabilidade jurisdicional. Sob o argumento de que compete ao Judiciario a efetivacao dos ditames constitucionais, especialmente do artigo 196 da Constituicao Federal, o numero de concessoes, via Poder Judiciario, de direitos que deveriam ser resguardados por politicas publicas aumentou significativamente, popularizando-se a concessao de medicamentos atraves de a