The article aims to study, from a sociopolitical approach, the process of health reform in Colombia, which took place in the last decade of the twentieth century. The study draws on documentary analysis to reconstruct the process of change, characterize the different proposed agency found political players and displays the tensions that arise when specifying and implementing the proposed changes. The study show some moments in the process of regulatory change, trends and controversial discourse among actors in order to evidence the complexity of a process of reform although appears to be exclusively technical is in its essence eminently political.