Health care system reform has enormous implications for the future of American society and economic life. Since the early days of the republic, 2 world views have vied for determination of this country’s political system: the view of the individual as sovereign vs government as sovereign. As they developed the foundations of our nation’s governance, the founders were heavily influenced by the Enlightenment philosophy of the late 17th and 18th centuries—the US Constitution sharply limited the power of central government to specific narrowly defined functions, and the economic system was largely laissez faire, that is, economic exchange was mostly free of government regulation and securing individual liberty was a high priority. This situation has slowly reversed—the federal government originally was narrowly limited, but now it dominates states and individuals. The economic system has followed, lagging by several decades, so although it still retains some features of laissez faire capitalism, federal and state regulation have produced a decidedly mixed economy.