In this paper, the mechanisms of social participation in the Colombian health system are analyzed. The perspectives of inquiry are the economic and political context of health in Colombia, the legal settings of participation between society and private companies in the health sector, and finally the aspects that hinder the proper relationship between these different actors. The conclusion is that in an environment in which health is managed by private actors, private economic interests prevail over general societal well-being. Thus, private actors are shown to hinder the implementation of health strategies designed for the needs and interests of the community.