**6. Conclusion**

As is obvious from the foregoing, the U. S. still lacks a primary care base for its health care system, despite a long struggle over many decades. Health care services are still treated as a commodity for sale on in a largely unfettered marketplace. Although the ideologic claim that the competitive free market will contain costs has been proven conclusively false, the political battle continues over the role of government vs. an open market. It has become obvious to much of the public and many health policy experts that the time has come to put in place a system of universal coverage based on a service ethic for the common good. As Winston Churchill observed many years ago:

*You can always count on Americans to do the right thing— after they've tried everything else.*

That time has finally come, so let us hope for the future!
