Abstract
Many millions of Americans are deprived of medical care because of inadequate and poorly distributed health resources. The cost of care has become the most potent single cause for concern, and much of the current governmental response focuses on this issue. The plethora of bills before Congress is considered in this paper and three examples advocating a less or greater degree of change are studied. The universities are responding in a variety of ways, and these include expansion of their service and educational bases into the community. The widespread creation of departments of family medicine is a new feature of American medical education and could constitute a major change in direction equal in significance to change resulting from the Flexner Report. Though greater emphasis on primary medical care is clearly accepted as important by both government and educators, the future is uncertain. Barriers and shortages should disappear in the years ahead, and a great resurgence of family medicine should reintroduce many desired features into practice which are now missing.

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