Summary
The main goal of this work was to make clear the dynamic of capitalistic transformations in medical practice by means of studying the pre-payment medical enterprises. The delayed character of the uprising and development of such enterprises was due to the interaction of multiple conditions envolving state policies as a result of health enterprises controversy of interests, working-classes and social security burocracy, as well as of the material and technological conditions of medical practice, the formation of a surplus in medical labor and investiments of private funds in this sector. The subordination process to the capitalistic relations was proved to have happened in an heterogeneous and contradictory way clearly shown by the coexistence of multiple forms of medical practice which are complementary to each others, within a process of social and tecnical division of medical labor.