Blockchain Papers

Kaoru Kurosawa, Shigeo Tsujii

No abstract is available for this record.

Donald Beaver, Joan Feigenbaum, Victor Shoup

No abstract is available for this record.

Tatsuaki Okamoto, Kazuo Ohta

No abstract is available for this record.

André Chailloux, Iordanis Kerenidis

In quantum zero knowledge, the assumption was made that the verifier is only using unitary operations. Under this assumption, many nice properties have been shown about quantum zero knowledge, including the fact that Honest-Verifier Quantum Statistical Zero Knowledge ($HVQSZK$) is equal to Cheating-Verifier Quantum Statistical Zero Knowledge ($QSZK$) (see ~\cite{Wat02,Wat06}). In this paper, we study what happens when we allow an honest verifier to flip some coins in addition to using unitary operations. Flipping a coin is a non-unitary operation but doesn\'t seem at first to enhance the cheating possibilities of the verifier since a classical honest verifier can flip coins. In this setting, we show an unexpected result: any classical Interactive Proof has an Honest-Verifier Quantum Statistical Zero Knowledge proof with coins. Note that in the classical case, honest verifier $SZK$ is no more powerful than $SZK$ and hence it is not believed to contain even $NP$. On the other hand, in the case of cheating verifiers, we show that Quantum Statistical Zero Knowledge where the verifier applies any non-unitary operation is equal to Quantum Zero-Knowledge where the verifier uses only unitaries. One can think of our results in two complementary ways. If we would like to use the honest verifier model as a means to study the general model by taking advantage of their equivalence, then it is imperative to use the unitary definition without coins, since with the general one this equivalence is most probably not true. On the other hand, if we would like to use quantum zero knowledge protocols in a cryptographic scenario where the honest-but-curious model is sufficient, then adding the unitary constraint severely decreases the power of quantum zero knowledge protocols.

Atsushi Takahashi

<!-- *** Custom HTML *** --> We associate to a regular system of weights a weighted projective line over an algebraically closed field of characteristic zero in two different ways. One is defined as a quotient stack via a hypersurface singularity for a regular system of weights and the other is defined via the signature of the same regular system of weights. The main result in this paper is that if a regular system of weights is of dual type then these two weighted projective lines have equivalent abelian categories of coherent sheaves. As a corollary, we can show that the triangulated categories of the graded singularity associated to a regular system of weights has a full exceptional collection, which is expected from homological mirror symmetries. The main theorem of this paper will be generalized to more general one, to the case when a regular system of weights is of genus zero, which will be given in [5]. Since we need more detailed study of regular systems of weights and some knowledge of algebraic geometry of Deligne–Mumford stacks there, the author write a part of the result in this paper to which another simple proof based on the idea by Geigle–Lenzing [2] can be applied.

Mike Burmester, Fred Piper, Yvo Desmedt, Michael J. Walker

No abstract is available for this record.

Gilles Brassard, Claude Crépeau

No abstract is available for this record.

Tatsuaki Okamoto, Kazuo Ohta

No abstract is available for this record.

Moti Yung

No abstract is available for this record.

Mihir Bellare, Silvio Micali

No abstract is available for this record.

Joan Boyar, René Peralta

No abstract is available for this record.

Yacov Yacobi, Zahava Shmuely

No abstract is available for this record.

Adi Shamir

No abstract is available for this record.

Mihir Bellare, Shafi Goldwasser

No abstract is available for this record.

Jens Groth, Steve Lu

No abstract is available for this record.

Hannibal Travis

In an information society, wealth and power are increasingly linked to access to knowledge and control over telecommunications media. Struggles over access to digital media in particular are presenting uniquely contentious First Amendment problems. The creation of about 200 million blogs worldwide has triggered legal action and legislative reform aimed at alleged trademark infringement by bloggers and cybersquatters. Authors and publishers seek expanded rights to curtail unauthorized digital uses for which they are not being compensated, and have sued Google for digitizing and indexing tens of millions of the world's books and periodicals. Finally, Google, Yahoo!, Microsoft, and other Internet and e-commerce firms are trying to beat back plans by the nation's cable and telephone companies to finance upgrades to their networks by levying discriminatory fees on search engines, as well as on Internet content providers and aggregators. Internet users have often been on the losing side of these controversies, as the economic model increasingly adopted by the Supreme Court is that in order to reward corporations for collecting or disseminating information, its free flow in print and electronic form must often be impeded, and its cost to the user increased. This model threatens to empower broadband companies, copyright holders, and trademark owners to restrict the right of the public to utilize digital media for purposes of free speech. This Article argues that digital media such as the broadband Internet, the World Wide Web, and the blogosphere should be at least as free as the press was at the time that the First Amendment was ratified in 1791. In other words, bloggers could not be enjoined or fined for tarnishing the trademarks or goodwill of their employers or other corporations, for trademark law did not prohibit trademark dilution or other non-competitive uses in 1791. Similarly, Web sites and search engines such as Google could not be restrained from digitizing, indexing, andproviding short previews of books and periodicals, for copyright law in 1791 permitted abridgements, adaptations, reviews, and other value-added uses of copyrighted work. Finally, the cable and telephone companies would not be at liberty to levy discriminatory access fees upondigital media outlets, for their ability to monopolize local telecommunications networks is a legacy of anticompetitive state and federal exclusion of new entrants over the past century in violation of the First Amendment. The framers of the First Amendment would no more have countenanced an attempt by Congress and the federal courts to allow private entities enjoying the fruits of past official monopolies to restrain the freedom of speech over an essential facility such as the Internet than they would have endorsed the creation of a series of local book publishing or newspaper monopolies. The framers presumed that information would flow freely and cheaply to citizens and consumers, enabling them to ascertain their true interests without difficulty, and to make decisions accordingly. As Congress considered ratifying the FirstAmendment, Madison declared that by it the liberty of the press is expressly declared to be beyond the reach of this Government. The Supreme Court has construed most of the other amendments in the Bill of Rights to provide at least as much protection against infringement asexisted under the common law in 1791. Opponents of net neutrality requirements have opined that the First Amendment rights of corporate owners of telecommunications infrastructure should trump the First Amendment rights of individual speakers and users of telecommunications media. Under this view, the foremost free speech interests on the Internet are those of broadband infrastructure owners, rather than the senders and recipients of Internet speech such as Web content, blogs, eBooks, or online videos. This line of argument misconceives both the distinctive character of the Internet andthe purposes for which the First Amendment was enacted. The Internet and its principal applications such as the World Wide Web grew as rapidly as they did because they were designed to be open, flexible, and uninhibited by gatekeeper control. The high degree of concentration in the broadband market, the inability of many consumers to switch broadband carriers, and plans by broadband providers to discriminate among different sources of Internet content combine to threaten the Internet as an open, decentralized, low-cost communications platform. TheFirst Amendment is not offended by regulations designed to ensure that firms awarded local telecommunications monopolies by the government exercise their power to restrict mass communication in a manner consistent with the public interest. The overriding purpose of the FirstAmendment is to ensure that readers, listeners, and viewers of public debates obtain access to a wide variety of facts and opinions so as to be able to discern the truth as best they can. Even privileging the speaker's perspective, surely the First Amendment interests of the creators, editors, and aggregators of Web sites, blogs, and online videos - rather than the supposed speech interests of the owners of the wires along which content travels - should prevail in the event of a conflict.

Ilan Hosiosky, Yossi Weiss, Racheli Magnezi

BACKGROUND: The Ministry of Defense budget constitutes 16% of the state budget. The budget for the Ministry of Health and for civilian health care is derived from the state budget. The health care funds receive their budgets from several sources. The capitation formula, which is determined by law, is the main factor that affects the size of the budget each fund receives. OBJECTIVE: The objective of this study is to describe the manner of planning, managing, monitoring, and controlling the budget allocated to medical services, which is a public budget for soldiers. METHODS: Several parameters are suggested for comparison, including the interface with the civilian health system, the method for budgeting a health care system, possible results of managing a medically centered budget, and the possibilities for monitoring the provided services. We also examine the potential for decentralization of authority. CONCLUSIONS: Managing the budget and locating appropriate alternatives, as well as the availability and accessibility of medical services, are important for procurement and for forming contracts with both military and civilian systems. Turnover based on updated information might serve to improve future health services.

Elmer S. Soriano, David M. Dror, Erwin Gaspar A. Alampay, Jolande

A sustainable health reinsurance system can be fashioned for the informal sector by mobilizing social and economic forces operating within individual communities. The economic analysis in part 1 of this book draws conclusions from success stories in industrial countries and failures in low- and medium-income countries. This analysis leads to the premise that decentralized development of microinsurance units, operating in a market segment left out by for-profit health insurance firms and by national schemes, can be stabilized financially through their affiliation with a reinsurance facility-Social Re' (part 1, this volume; Dror and Duru 2000, pp. 30-40; Dror 2001). Dror, Preker, and Jakab, in chapter 2 of this book, explain how the sociological dimension would theoretically affect the performance of a microinsurer. Findings of the Institute of Medicine reaffirm the active interplay of biology, psychology, behavior, and society in determining people's health attitudes. The institute further reports that, although people's attitudes and actions can readily be altered, these changes need support and reinforcement over time to guarantee better health. Attitudinal and behavioral changes are best prolonged through interventions at multiple levels, from the individual to society at large (Institute of Medicine 2001, pp. 1-1-1-8). Efforts are required to address the psychosocial factors that influence health status, including, for example, proposing measures such as microinsurance to persuade individuals to accept a healthy way of life and permanently modify their health behavior. Microinsurance schemes provide individuals, households, and communities mechanisms for financing their health through group risk-pooling mechanisms, leading to a sustained improvement in their access to health services. Higher up on the social scale, well-evaluated interventions at the organizational level should be encouraged, giving credit to organizations' vital role in influencing individual behavioL Still farther up the scale, community involvement in health-promotion strategies should not be overlooked, because some disease-related factors that are beyond an individual's capacity to modify can be significantly minimized through community efforts. Community empowerment, social support, and other values that protect members from stress are strengthened through community-level interventions. Finally, interventions at the societal level recognize the role of collective organizations influencing individuals' everyday existence (Institute of Medicine 2001, pp. 1-1-1-8). Underlying assumptions are that members' affiliation with microinsurers is voluntary (individuals can join, stay enrolled, or withdraw at will) and that microinsurers will voluntarily join Social Re. A clue is therefore needed about the considerations that shape individual and collective choices. According to one opinion, The underlying economic motivation for joining a microinsurance unit is assumed to be a desire to seek reciprocity in sustaining risk-sharing arrangements among essentially self-interested individuals (Dror and jacquier 1999, p. 79). This assumption implies that joining a microinsurance unit (and Social Re) is a predictable, rational economic choice by self-interested individuals to maximize total utility (optimal choice theory), and an act of reciprocity, in which giving and getting are somehow linked. According to the utility motive, people will join if they can benefit from joining. However, considering that many people will pay a health insurance premium without getting any cash benefits (if they stay healthy), is it really clear what each individual would consider as his or her exact utility from being insured? As Herrnstein points out, because utility cannot be directly observed, it must be inferred from behavior, from the choices individuals make. Thus, utility is synonymous with the modem concept of reinforcement in behavioral psychology (Herrnstein 1997, p. 226). Dror and Jacquier mention a second motive for joining a microinsurance unit: people's desire to improve their health by controlling their living and working conditions. This control is linked to a deep-rooted human need to seek voluntary and repeated interaction with others in daily life (Dror and Jacquier 1999, p. 80). These interactions may provide material reciprocity or they may reflect altruistic, nonmaterial interactions. The three authors mentioned above suggest that, to understand how microinsurers can attract and retain their clients, they have to know what shapes their clients' behavior in their specific operating context. The same reasoning applies to a microinsurer's decision to affiliate with Social Re. Since Social Re will be piloted in the Philippines, this examination will be done with reference to that country and culture. The rest of this chapter will provide an overview of the social and institutional structure of Philippine rural and informal society and the attitudes toward solidarity, risk, and insurance that influence choices and help shape the role of microinsurance. This role is quite different from what could be conjured from classical economic theory on utility, as will be shown. This analysis leads to the conclusion that in the rural Philippines, the introduction of insurance and reinsurance hinges as much, perhaps more, on the structure of society than on the profile of risks and the existence of a market for insurance.

NAHUM A. FREEDBERG

In the differential diagnosis of supraventricular tachycardia, pacing maneuvers or observation rarely provide a diagnosis when used individually.1 The introduction of transcatheter therapy for cardiac arrhythmia transforms electrophysiology from an exclusive, scholarly, almost Talmudic, field to an interventional goal-oriented field where successful elimination of the arrhythmia by “burning” often serves as “proof” of the arrhythmia mechanism (Learning by Burning). In a series of papers by Callans et al.2–4 published in this Journal, the term “learning while burning” was coined, emphasizing that in contrast to the goal oriented approach, ablation procedure is indeed a powerful tool for understanding the interplay between anatomical substrate and the pathophysiology of clinical arrhythmia. The authors in the present Journal article5 put a new twist on that concept by utilizing junctional beats induced during ablation procedure of AV nodal slow pathway modification to gain a new insight to the differential diagnosis of atrioventricular node reentry tachycardia (AVNRT) versus junctional tachycardia (JT). The authors should be applauded for a meticulous execution of the study protocol and a rigorous validation of their findings that showed convincingly that the mean H-A during JT is shorter than the mean H-A during AVNRT and that the mean delta H-A (defined as retrograde H-A during ventricular pacing minus H-A during tachycardia) is negative during AVNRT, as opposed to positive during JT. In the study design, both AVNRT and JT were induced in each patient. When these measurements were compared on an individual basis (meaning that every patient's measurements during AVNRT were compared with his or her own measurements during JT controlling for variability between patients), these findings hold true in most patients (see Figs. 2 and 3). How can we explain these finding based on our present knowledge about the electrophysiological properties of these arrhythmias? AVNRT is the most common cause of supraventricular tachycardia in patients referred for electrophysiological study (EPS).1 The “common,”“typical,”“slow-fast” type is present in over 80% of all cases of AVNRT.6 In a simplistic model, AVNRT results from reentry involving two anatomically distinct AV node structures7,8 (i.e., “slow” and “fast” pathways). In “slow-fast” AVNRT, the reentry circuit consists of anterograde conduction through the slow pathway and retrograde conduction by the fast pathway with the earliest retrograde atrial activation in the “fast pathway region” at the apex of the triangle of Koch, recorded on the His-bundle electrogram from the right septum.9,10 Unfortunately, life is not that simple: the three-dimensional anatomy and cytoarchitecture of the AV junction is complex11,12 and the exact location of the atrionodal connections and slow and fast pathways are still controversial. Although several elegant models based on functional characteristics of different areas of the compact AV node and surrounding structures were proposed to explain dual-AV node physiology, the sheer bulk of the literature on the subject and the ongoing debate attest that none of them is proven.13,14 In as many as 40% of the patients with AVNRT, there are multiple AV nodal pathways.15 Even in patients with typical AVNRT, recording with close-spaced electrodes in the His, coronary sinus (CS), and the slow-pathway areas has shown that there is heterogeneity of the retrograde fast pathway conduction pattern.16 Recording of the His bundle potential from the right and left sides of the septum has shown that the earliest retrograde atrial activation during AVNRT is most often recorded on the left side of the septum.17 Thus, it is not surprising that there is a considerable variability in H-A intervals in patients with typical AVNRT, making it difficult at times to differentiate between typical AVNRT and other arrhythmias (including JT) based on H-A interval alone. According to the slow-fast pathway model, the retrograde atrial activation sequence during right ventricular pacing at the tachycardia cycle length, immediately after typical AVNRT, propagates retogradely from the His bundle through the lower common pathway to the fast pathway, and should be similar to the activation sequence during typical AVNRT. Retrograde H-A interval during ventricular pacing (H-Ap; measured from the end of the most proximal His potential to earliest A) is the sum of retrograde conduction time of the lower common pathway and the retrograde fast pathway. The H-A of typical AVNRT (H-At) according to this model is retrograde conduction time of the fast pathway minus anterograde conduction time of the lower common pathway. The difference between H-Ap and H-At (so called delta H-A) equals retrograde plus anterograde conduction time of the lower common pathway13 (assuming that the retrograde fast pathway conduction time is identical during pacing and AVNRT). A positive delta HA suggests that a lower common pathway is present. A negative delta HA, which, in fact, was found in the present study5 and by others,18 cannot be explained by this simple model. Although there are several explanations for this phenomenon, including difference in conduction velocity, activation path,19 and a combination thereof,13 a negative delta HA probably reflects a very short or an absent lower common pathway. Automatic JT as described by Coumel20 is a rare arrhythmia seen mainly in the pediatric population21 and postcardiac surgery21,22 and very rarely in adults.23 In the few cases studied, abnormal automaticity within or in close proximity to the His bundle was found.24–26 JT is frequently seen during radio frequency ablation using the AV node modification by slow pathway approach. In fact, the presence of JT is associated with successful slow pathway ablation.27,28 The pathophysiology of JT during ablation is thought to be enhanced automaticity due to heating of the tissue29,30 or local release of norepinephrine.31 Studies in pig and rabbit heart models have shown that heating in a discrete area located in the middle of the triangle of Koch that was located in close proximity to the compact AV node induced JT. In that area, no slow pathway potential was seen and it was distant from the site of earliest retrograde atrial activation. There was a large variation between individual animals regarding the location of these sites.30 In canine blood-perfused atrioventricular node preparations, JT was induced by heating anterior to the CS os with the earliest retrograde atrial activation site at the His-potential recording site or in the middle of Koch's triangle. After interruption of the posterior input to the AV node, atrial activation during JT spread from the low posterior to the high anterior septum.29 In humans, VA block during junctional ectopy is a harbinger of AV block in patients undergoing RF ablation of the slow pathway,27 suggesting that the retrograde atrial activation during JT may involve the His area or the common lower pathway. However, in that same paper, the authors observed that “VA conduction should be expected during the junctional ectopy that accompanies slow pathway ablation, even when there is poor VA conduction during baseline ventricular pacing,” and that the AV block was proximal to the His.27 These astute observations suggest that the site of VA conduction during JT is proximal to site of VA block during ventricular pacing. Wagshal et al.32 reported that higher temperature lesions simultaneously abolish all slow pathway activity as well as the focus of JT, which suggests that the JT source is located or triggered by slow pathway tissue. In a study by Lee et al.,33 atrial activation sequences were assessed by comparing H-A interval (measured at the high right atrium) during various forms of AVNRT and JT induced by ablation. In 27 patients with slow-fast AVNRT, H-A during JT was shorter than during AVNRT: 58 ± 24 msec compared with 68 ± 21 msec, respectively (P < 0.01). In the present study,5 a similar trend in mean H-A interval was observed: 35 msec versus 54 msec during JT and AVNRT, respectively. These findings call into question the concept that JT seen during RF ablation originates or has an exit point near the His area as described in the rare “de novo” automatic JT.24 Obviously, if a junctional beat originates near the His, distally to a common pathway, the H-A interval during JT will be longer than H-A interval during AVNRT that has a more proximal turn-around point to the fast pathway. In that situation, one would expect near-zero delta H-A in JT and positive delta H-A in AVNRT—in contrast to the finding of present5 and other33 studies. Studies in animal models and high resolution mapping in humans have demonstrated several mechanisms that can account for the shorter H-A interval during JT compared with AVNRT: changes in activation sequences that may cause direct activation of the atria, compact AV node,29 anisotropic spread from one more AV nodal transitional zone,34 fibers connecting to the fast pathway,35 or fibers connecting the slow pathway ablation area directly to the fast pathway in a more proximal location.33 Local heating may cause an increase in conduction velocity due to a direct effect30 or adrenergic stimulation. A recent study in a canine complete AV block model has shown that the application of RF energy caused a shift from the distal portion of the AV junctional area to a more proximal one. This enhanced junctional automaticity was suppressed by esmolol but not affected by atropine.31 In conclusion, differential diagnosis of a short RP tachycardia can be challenging. The paper by Srivathsan et al.5 adds a valuable new technique regarding the diagnosis of JT versus AVNRT, as well as provides insight into the electrophysiological mechanism of this fascinating and elusive arrhythmia. Further research is needed to ascertain whether these findings can be extended to the clinical forms of JT. Acknowledgment: The author would like to thank Dr. Shaul Atar for critical review of the manuscript.

Purwanto Subroto

This study examined the current decentralized system in Indonesia for increased disparities in educational expenditures across districts. It also examined the impact of these on the quality of education at public junior secondary education. The study used the most recently available data from the Ministry of National Education (MONE) and Central Bureau of Statistics (BPS) covering 1999/00 and 2002/03. These data measured district level school expenditures, demographic and socio-economic variables.The study found that the current decentralized system in Indonesia increased fiscal capacities for education at districts. Unfortunately, increases in the fiscal capacities for education led to increased disparities in education expenditures per student, creating growing gaps in fiscal capacities for education across districts. Districts which received larger general allocation funds (DAU) per capita were also more likely to allocate more funding for education, whether or not they were poor or wealthy districts. This fact was reflected by the finding that district GRDP per capita in sub-national regions of Java-Bali and Sumatera had no impact on districts' education expenditures per student. In addition, the sub-provincial districts of the Kota (more urban) and Kabupaten (less urban) also differed in the way that they allocated funding for education. The Kota in the Sumatera region tended to allocate significantly more for education than did the Kabupaten. At the same time, the Kota in Java-Bali did not allocate significantly more for education than the Kabupaten. Teacher compensation was national, so funding variance was measured by locally controlled variables. The most significant impact on student achievement were teaching and learning process expenditures (textbooks, libraries, labs, field trips, etc.). The study concluded that increased funding, combined with more efficient budget allocations, were keys to quality improvement. Policy recommendations include: a) targeting DAU transfers to reduce the gaps in fiscal capacity for education across districts; b) rewarding districts with effective budget allocations that support improved student achievement; and c) placing education closer to the center of development and security policy. Better government monitoring and district transparency is needed for this major investment. Improved policy research and reporting capacities are needed, including annual reports on decentralization policy implementation.

Albert J. Jovell, Robert J. Blendon, María Dolors Navarro, Channtal Fleischfresser · 7 authors

BACKGROUND: Fifteen years ago, public opinion surveys in Spain showed substantial dissatisfaction with the health-care system. Since that time, health-care in Spain has undergone significant changes, including a decentralization of the system, an increase in spending and a change in the way the system is financed. OBJECTIVE: This study examines how Spanish citizens rate the performance of their health system today, both as compared with other sectors of society and as compared with earlier time periods. METHODS: Data are drawn from nationally representative telephone surveys of the non-institutionalized adult Spanish population (age 18 years and over). The study was carried out in two phases: October-November 2005 (n = 3,010) and January 2006 (n = 2,101). RESULTS: The majority of the Spanish population thinks the health system needs to be changed. The problems cited relate mostly to long wait times to get health-care. Nevertheless, over the last 15 years, the proportion of people who have very negative views about the health system has decreased by half. The majority believes that not enough money is spent on health-care, but few people would support an increase in taxes to provide additional funding. The survey finds the National Health System's institutions and health professionals to be more highly trusted than other institutions and professional groups in the country. CONCLUSIONS: Government policy-makers in Spain face a dilemma: the public wants more health spending to decrease wait times, but there is substantial resistance to increasing taxes as a means to finance improvements in the system's capacity.

Cristiani Vieira Machado

This paper analyzes the policy model of the Brazilian Ministry of Health from 1990 to 2002. The methodology included interviews with key actors in the national health policy, document review, and analysis of the Federal budget and official databases. The Brazilian Ministry of Health underwent major changes under the influence of the health reform agenda and the liberal State reform agenda prevailing in the 1990s, shaped by two movements: institutional unification of national policy control and political/administrative decentralization. The Federal role was diminished in terms of direct services provision, and there were changes in financing and regulation. The model in the late 1990s featured strong Federal induction of States and municipalities and the adoption of market regulation strategies. There is no record of a long-term planning effort, which favors distortions in the Federal intervention model and hinders solutions to structural problems in the Brazilian health system.

Andreas Büsch

“Front-loading” primaries and caucuses - the movement of state delegate selection contests to the beginning of the nomination calendar - is problematic for the integrity of the presidential nominating system. Because it results from decentralized decision making by self-interested states, front-loading also poses a problem for federalism. Indeed, most proposed remedies for front-loading would impinge on federalism in some manner. In analyzing those remedies, one must assess their interaction with federalism both procedurally and substantively. For example, a federally imposed national primary would be harmful to federalism on both dimensions; regional primaries negotiated among states would be best for federalism procedurally but are of dubious efficacy; the national parties have an ambiguous relationship to federalism; and a change in federal campaign finance rules would seek to combine a centralized process with a decentralized result. The best solution might be to use available central levers to try to change campaign dynamics and thus the incentives for states to schedule their primaries early.

Vanessa Elias de Oliveira

This thesis examines the Brazilian municipalism after the Constitution of 1988. It verifies the municipalities performance in the provision of local health services vis--vis the decentralization of this policy due to the creation of the SUS (Unified Health System). It argues that the process of health services decentralization developed during the 90's presented two different steps: the step of autonomist decentralization, between 1990 and 1998, when the municipalities were totally free to choose their own local health policies; and the step of the driven decentralization, after the creation of the Basic Assistance Floor -PAB, when the municipalities started receiving targeted incomes, which could be used exclusively for specific health programs, determined by the Health Department. However, as we demonstrate, the both steps were incapable to decrease the extant regional inequalities in what regards the supply, the access and the financing of municipal health services. To summarize, we demonstrate that the inequalities in health produced by our federalism were not balanced through the outline of policies that municipalized the health services.