Notwithstanding high taxes, enormous expenditures, and many promises, the standard of health care services provided by successive Ontario governments has continued to deteriorate. Medicare cannot be continued without changes from the current form of unrestrained demand for “free” services coupled with central bureaucratic planning and government mandated supply restrictions. Growing private sector involvement will help, but competitively priced, widely accessible, high quality health care will only be available for everyone to the extent state involvement is eliminated. Since this cannot be accomplished overnight without some short term hardship, transition measures will be needed. However, ultimately everyone will be personally responsible for their own health care in a libertarian free market system.