Reforming health care will not be easy, but it's not impossible. Other countries have done it, and they have lower costs and better overall system performance than the United States (5 - 7). That we can learn from their experience is the premise of an ACP position paper in this issue (8). This premise rejects the concept of American exceptionalism (the belief that the United States is unique among developed nations because of its historical credo, its evolution as a nation, and its unique institutions), as the authors rightly claim that we can and should learn from other countries. Written by ACP staff and J. Fred Ralston Jr., MD, for the ACP Health and Public Policy Committee and approved by the ACP Board of Regents, the article describes the U.S. health care system, compares it with those of other industrialized countries, and proposes changes that have worked in other countries. The article also recommends that the country seriously consider a single-payer system as another way to provide universal access to health care. Although countries have achieved universal access with pluralistic insurance systems, not unlike our own, both can achieve the greater end that should be our highest priority: equal access to basic health care for every citizen.