Of course, we recognize that many problems must be surmounted in order to increase the efficiency and effectiveness of our health-care system. The logistics of rectifying the shortage and maldistribution of health personnel and facilities must be solved, as well as the education of the population in public health and routine preventive health care. But significant changes in the present system will not occur unless we first alter our conception of the utility of free enterprise in medicine. Such a value change will require many Americans to accept that there may well be weaknesses in our present institutional structure. But values change slowly, and such changes often need to be precipitated by some sort of crisis. We are in that crisis now. Whether the change is agreeable to the medical profession and best for the population will depend on how fundamental our desire is to redress the inequities in our health care system. As the richest nation in the world, with a gross national product over a trillion dollars, we have the resources to solve many of the problems related to health care. The American people must decide whether it is not time that we altered our archaic tradition of having sick people compete as consumers in a free market for care. They must consider whether it is not time we stopped letting the free marketplace influence the quality, standards, and delivery of health care in the United States.