This book analyses the impact of courts and litigation on the way health systems set priorities and make rationing decisions. It focuses on how the judicial protection of the right to healthcare can impact the institutionalization, functioning and centrality of Health Technology Assessment (HTA) for decisions about the funding of treatment.

Both developing and developed countries face an increasing mismatch between what patients expect to receive from healthcare and what the public healthcare systems can afford to provide. Where there has been a growing recognition of the entitlement to receive healthcare, the frustrated expectations with regards to the level of provision has led to lawsuits challenging the denial of funding for health treatments by public health systems. This book analyses the impact of courts and litigation on the way health systems set priorities and make rationing decisions. In particular, it focuses on how the judicial protection of the right to healthcare can impact the institutionalization, functioning and centrality of Health Technology Assessment (HTA) for decisions about the funding of treatment. Based on the case study of three jurisdictions - Brazil, Colombia, and England - it shows that courts can be a key driver for the institutionalization of HTA. These case studies show the paradoxes of judicial control, which can promote accountability and impair it, demand administrative competence and undermine bureaucratic capacities. The case studies offer a nuanced and evidence-informed understanding of these paradoxes in the context of health care by showing how the judicial control of priority-setting decisions in health care can be used to require and control an explicit scheme for health technology assessment, but can also limit and circumvent it. It will be essential for those researching Medical Law and Healthcare Policy, Human Rights Law, and Social Rights.

"This work offers a rare perspective of the interplay between the judiciary on one hand and institutions responsible for making decisions about healthcare investments, on the other. Studying real examples of priority setting institutions and of court rulings from Latin America and the UK, it offers valuable lessons for policy makers, legal experts and human rights advocates, demonstrating rather clearly that all decisions carry trade-offs and that in the strive to realise health as a human right, good intentions alone may result into perverse outcomes for the poorest and sickest amongst us." Kalipso Chalkidou, Professor of Public Health at Imperial College London and founder of NICE International. "A challenging dissection of the impact of courts on health care decision-making. Learned, well-researched and written in a clear style, this book's close scrutiny of three jurisdictions leads it to ask some very hard questions about whether judges - even well-meaning ones - might not be doing more harm than good in this vital arena". Conor Gearty, Professor of Human Rights Law in the LSE Law Department.