What does the Kappian perspective of social costs bring to the public health debate?

Background: this theoretical essay was produced from the reflections and seminars of the PhD Programme in Governance, Knowledge and Innovation, of the Faculty of Economics - University of Coimbra and in the author's personal experience as a public health specialist. The main objective is to deepen the discussion on the concept of social costs in Kapp (Frigato, 2006), and its relationship with public health, also reflecting on the role of the State in the implementation of Public Health Policies. Methods: we follow the guidelines of Meneghetti (2011), understanding that in the essay, the object is studied in its dialectical condition, not necessarily requiring empirical proof. It starts from the guiding questions for theoretical argumentation, seeking to understand the object through associations or analogies, without the formalism of traditional scientific technique. Results: we can see that the Kappian perspective on social costs, expands its reach to the political level, and the concept can serve as a basis for the analysis of public policies. In particular, on public health, this concept contributes to the reflection of the role of the State, in social protection and in its permanent relationship with the market. Conclusion: the Kappian perspective perceives the circularity and interdependence in the relationship between health and the costs of capitalism, favours new insights and a critical reading of the associated institutional political phenomena, power games and conflicts around the public-private relationship in health.