Changes in the Brazilian health system are discussed from the point of view of social policies. Taking social exclusion as the central question to be faced by social policies and contra-reform as the opposite of the virtuous and necessary reform of the State, the article analyzes Brazilian health policies, chiefly regarding the so-called Sanitary Reform and the National Health Service (SUS). It is argued that the articulation between the reforms of the health system and economic policies should be promoted having in view a new development pattern, with strong social foundations and ethically and politically oriented towards social inclusion.