In summary, the current U.S. health care system is broken. It is a high-cost, mediocre system. Access is a major problem. Pharmaceutical costs are out of control. Malpractice insurance costs are egregious, and there is no question that solutions will be difficult. In my opinion, leadership will not come from the Executive Branch of our government, and Congress is so partisan at the present time that the elected officials are simply impotent in dealing with health care and other problems. Until recently, organized medicine has not provided any solutions either. I believe the American College of Surgeons has been taking a leadership role. However, long-term solutions will require more than tweaking the current dysfunctional system.