The paper discusses the changes in the way State new responsibilities and purposes are being viewed by Brazilian society and government, after the moving on of the reform process outlined in the political agenda for the 90s. It highlights the consequences of this reform process upon the Brazilian Health System, addressing the current dilemmas public institutions shall face, due to their simultaneous commitment with social justice and the new methods of management and control.
Governance; Accountability; Representative/Principal Relation; State reform