The institutionalization of the Unified Health System (SUS), guided by principles of universalism and solidarism, can be viewed under the influences of the tensions between market forces and citizenship in the re-democratization context that the country experienced, adapted in the political conflicts during the elaboration of the 1988 Constitution, in the economic crisis that has characterized the lost decade and in the decreasing role of the State as development motor. The article is a theoretical study, and has as premise the fact that the world economical trans nationalized scenario, with consequent flexible social warranties imposed by financial capital in the welfare States, has structural repercussions for developing countries , like Brazil, putting at risk the implementation of the principles and guidelines of SUS. It aims to: a - To analyze the resignation of social policies in capitalism and the sketching of the crisis of the Welfare State ; b - To put in context of the health policy in Brazil the current transformations of the capitalism and redefinition of the role of the State , analyzing the repercussions for the implementation of SUS; c - And to point possibilities for the facing of the problems regarding the implementation of SUS through the health care policy (handling of help-power for the (re) construction of the autonomy of subjects). Face the ambiguities of a system of health that aims equity, in a conjuncture dictated by market forces, the proposal is to strengthen the democratic control of the civil society on the implementation of public policies.
Health Policy; Unified Health System of Brazil; Welfare State