The health planning program developed under P.L. 93--641 is attempting to establish "community trusteeships" for health care in communities across the nation. It is based on a series of assumptions concerning public participation and involvement that are likely to remain viable for some time. Because of great local and state variations, it is difficult to measure performance on a nationwide basis; on balance, the record is positive. The program needs to be treated with patience, a very scarce American characteristic. The lack of a better, realistic alternative is the strongest argument for its continuation.