The projected impact of the recent U.S. elections on federal health-care policies and programs is discussed. The elections brought Ronald Reagan to the White House, Republican control to the Senate, and a conservative majority to the House of Representatives. The voters have thus produced a mandate for an end to government intervention as the solution to all the nation's ills. The new power base in Washington will increasingly turn to private industry for provision of health-related services. Costs under a privately based system will be controlled by competition, which is the basis for free enterprise. The nation is at a crossroads in health-care policy. An aging population is in need of more health services, while the government, faced with limited resources, has been moving toward rationing services. Costs must be held down in the short run by voluntary efforts; promoting increased competition provides long-range hope for cost control. Today's leaders should seize the opportunity offered by the new conservative focus of the federal government to shape a viable health-payment system for the future.