[A health policy perspective. 20 years after the Lalonde report]

In 1974 the report called "A new perspective on the health of Canadians" known as the Lalonde report was published. In that report health determinants were defined, and importance was given to factors outside of the health care system to improve and to preserve health. In this paper we analyse the methodology and the conceptual ambiguities observed on the development of that model, as well as the negatives consequences for the health care system that could derived from it. Finally we propose our point of view of the health care system as a public policy which should be responsible of producing services of prevention, diagnosis and treatment, at a reasonable cost.