As indicated in the title, the focus of this essay is on where we should go from here and not the how, which is addressed by other authors in this issue. I am assuming that there is probably a general consensus as to where we should be heading with health care reform, but there may well be some strong differences as to how this can or should be attained.

In the summer of 1966, a year after the enactment of “Medicare,” I listened to Harry Becker, then the Executive Director of the New York Academy of Medicine, discuss the significance of the new health legislation and further changes that were likely in the near future. His analysis was that, after numerous attempts over many years, the United States was finally on the verge of implementing universal health insurance for all Americans. The next step would be health insurance for children, “Kiddicare.”