The research captures the various forms of real and symbolic representation of citizens about priorities in health by conducting and analyzing interviews with people involved in decision-making processes from various functions within the Colombian Health System. Using a qualitative approach , based on the concepts and tools of grounded theory of Strauss and Corbin and freedom Sen agency , you will find that it is given little importance and significance to the opinions of citizens , confusing or rather replacing with their own interests. Finally building a theory based on the facts, which explains the loss of social ties between representatives and the subject itself of its representation , due to the dominance of technocratic culture where technical tools such as data , information , risks and regulations, are more important than who suffer the needs in the system.