This study reflects on reforms in health systems and social policies within the framework of the so-called public sector reforms. The point of departure is a review of various explanations for the crisis in the Welfare State, present in the literature from the 1990s. Social policies, at the heart of the crisis, are heavily challenged. What we intend to demonstrate is that this argument plays a specific role, that of introducing neoliberal changes into economic policy, in which the economic tools used generate abstention by the state from the social sphere, deregulation of national economies in favor of the free market, and the fundamentally oversized role of the international financial market. Within this context we analyze the social security and health system reforms. The final part of the article deals with current difficulties in social policies, focusing the debate on a mapping of possible alternatives for developing social and health policies.