IN THIS ARTICLE is analysed the Health Care Plan (Plano de Assistencia à Saúde - PAS) of the municipality of São Paulo from the perspective of the health system management and of preservation of social rights. It is presented a brief historical retrospective of the construction of health as a social right in contemporary societies, and a picture of health policies in Brazil in recent years emphasizing its decentralization process towards the municipal level. It is also examined the PAS as a management alternative and it is concluded that market forces are unable to regulate it and that it has ideological inconsistencies when faced to the liberal principles in force in the health sector. The author finishes the article with a brief balance of the legacy provided by this management experience.