Waiting to live

the impact of the lack of criteria in the SUS waiting list for cardiac surgeries

Abstract

Context: Cardiovascular diseases are among the main causes of death in Brazil, requiring high-complexity procedures that put pressure on the Unified Health System (SUS). In this context, the lack of objective and transparent criteria for managing the cardiac surgery waiting list generates inequalities in access, undermining constitutional principles such as universality, equity, and isonomy. Problem: The core issue lies in the subjectivity of medical assessments and the absence of a unified prioritization system, which encourages patients to resort to the Judiciary to secure their right, fueling the phenomenon of health judicialization. Objectives: This study aims to analyze the impacts of the absence of clear regulatory criteria in the SUS waiting list for cardiac surgeries and its repercussions on judicialization, seeking to identify management alternatives that ensure greater fairness and transparency. Method: The method adopted was a bibliographic and documentary review, combined with the analysis of national case law and international models of queue organization. Results: The findings indicate that although there have been recent efforts by the Ministry of Health to expand installed capacity and reduce waiting times, the measures remain insufficient in view of the high repressed demand, the shortage of professionals, and the lack of systemic integration. International experiences, such as e-SIGIC in Portugal and the New Zealand prioritization model, show that regulation systems based on ethical, clinical, and transparent criteria can improve equity. Conclusion: It is concluded that the adoption of similar practices in Brazil, along with structural and regulatory investments, may reduce judicialization, strengthen public confidence in SUS, and consolidate more efficient governance for specialized care.