This paper explains the historical reasons for the reappearance, since the middle of the 20th century, of social issues in the medical context of capitalist countries. The author interprets the rise of a community trend in medicine as one of the solutions that capitalism is proposing for the problems of public health. He considers that primary care coverage extension projects provide a means to attend to minimal levels of social demand, as well as basic conditions for the protection of previously neglected populations, without changing social relations or significantly diminishing productive investment. On the contrary, the consumer market will in many cases be expanded by new forms of demand. The contradictory nature of "community" services under capitalism is analyzed so as to provide a basis for the design of a strategy that takes into account the interests of the people.