Racionamento dos cuidados de saúde e a participa？？o da sociedade: revis？o do debate

introduction: the traditional discretionary model to set priorities in health care have been questioned by policy makers who seek to address this issue more explicitly. setting priorities in an explicit way has sparked an intense debate, especially and particularly in what concerns economics contribution and public involvement. material and methods: a literature review allowed not only an account of the debate about the evolution of the process concerning the setting of priorities within the health care services during the last three decades but also to describe the problematic discussion related to the community participation in the rationing debate, as well as to know some international reforms that tried to implement a more transparent rationing process. results: alongside with the reforms to adopt systematic principles to ration health care services, there is a debate about the role that population should play in that process. although there is some consensus that population should be more involved, there is no consensus about the limits and model of participation. the task, in practice, has proved to be complex and a source of conflict. conclusions: the implementation of a more explicit and transparent health care rationing process is still under debate. the solutions seem to depend on the political will and the cultural context of each country.