RESUMO
This is a document presented to the Chilean Academy of Medicine by the Health Minister, the Economist Carlos Massad. First of all, he refers to the general context of the reform, that he considers a process and not a breakpoint. Afterwards, he enumerates the change tasks: to generate awareness of the change and to convert health in a State issue; to adequate programs to population's new health profile; to install new management instruments in the health system; to descentralize decisions and to promote the participation of beneficiaries; to establish incentives and to flexibilize the Health System and to introduce correctives to private health insurance. He believes that Chile must drift to a economical protection system for universal and solidary health events. The additional assurances that people wants to buy, must be delimited