As relações de consumo e os consumidores hipervulneráveis com autismo: as práticas abusivas das operadoras de planos de saúde

Abstract

This investigation aims to address the abusive practices of private health service providers, especially with regard to the issue of limiting treatments for patients with autism spectrum disorder (ASD) imposed by health plan operators. Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by communication difficulties, difficulty in social interaction, as well as the presence of repetitive or restricted behaviors and/or interests. Treatment for patients with autism spectrum disorder involves early, high-intensity, long-term intervention through multidisciplinary teamwork. Health plan operators adopt practices aimed at restricting these therapeutic treatments necessary for the development of patients with autism and thus reducing the costs inherent to these coverages. The National Supplementary Health Agency (ANS) resists specifying a list of mandatory coverage procedures for health plan operators in relation to people with autism spectrum disorder. Law No. 12,764/2012 - Berenice Piana Law - recognizes autism spectrum disorder as a disability for all legal purposes. Consumers with ASD are hyper-vulnerable consumers because they are vulnerable because of their position as consumers and, at the same time, they are vulnerable as people with disabilities. Consumers with ASD, due to the peculiarities of the disorder, are often affected by different dimensions of vulnerability, highlighting their position of heightened hypervulnerability or multiple vulnerabilities. The jurisprudence of the Superior Court of Justice is predominantly favorable to consumers with ASD in their claims against health plan operators, highlighting the influence of the normative resolutions of the National Supplementary Health Agency in the resolution of cases. The investigation concluded that the legal protection given to consumer relations established between hypervulnerable consumers with autism and health plan operators prohibits the abusive practice of these private health service providers, especially with regard to the limitation of therapeutic treatments essential to the development and quality of life for these consumers. It also pointed out recommendations regarding objects that require further study in future studies and institutional measures aimed at improving the protection of consumers with ASD. The methodology used for the development of the work chose the inductive approach method. The research techniques used were bibliographical and documental. The procedure was monographic.