Abstract
A tentative analysis is made of the recent São Paulo experience in health care management, in which the chief guideline has been to create institutional space for grass-roots and health worker participation within the State apparatus. The analysis takes Brazil's recent health policies and the so-called Sanitary Reform movement as reference points. The issue is approached from the angle of democracy and democracy's possibilities in the context of a society characterized by tremendous social inequalities, and in the context of the current international and national neoliberal offensive.
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