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Brazil was under military rule from 1964 to 1985. Once the nation returned to democratic rule the new Constitutional Charter on Health closely linked health and health care to national economic and social policies. Health care was defined as a universal right of all citizens with the state charged with guaranteeing that right. The Unified Health Care System (SUS) was established integrating all public health care services and supplemented by private facilities in a decentralized regionalized and hierarchical network. Implementation of the SUS however sparked a series of conflicts of interest. Users therefore have yet to realize the level and quality of health care guaranteed in the constitution. Increased decentralization of the system is sorely needed before the constitutional goal is achieved. The constitutional framework the SUS resource allocation and the reimbursement of providers under the SUS the capacity and accessibility of health care services the private health care sector and health care financing and expenditure are discussed.