This article analyzes two opposite traditions in relation to the concepts of " decentralization" and " local power" (Brazilian social thinking and the Tocqueville based matrix) due to the role given to these concepts by the Brazilian Constitution of 1988. These concepts were considered capable of making viable democratic participation after the end of the military dictatorship. It also analyzes how the Brazilian pro-democracy arrangement and participation has been reconfigured by the third industrial revolution, which the economic and social relations that sustain capital more flexible and precarious. Specifically, it examines the political response (in a broad sense) of the Brazilian state via public health policies, notably the Single Healthcare System (SUS) - to this clash of conflicting forces. It also observes how federative factors related to SUS allow understanding the dynamics of democracy, participation and citizenship (in various dimensions) in Brazil.
democracy; participation; decentralization; capitalism; citizenry