Earlier chapters have highlighted the influence the medical model of health has had on both the philosophy of health care and the structures devised to deliver health care including dental care. The overriding influences of the medical model are the downstream focus on treatment of disease and the communication gap caused by differing concepts of health and need held by lay people and health professionals. Problems with health care delivery operate at a macro level (i.e. overall policy for and structure of health care) and at a micro level (how health care is delivered, one-to-one communication, and interaction with the patient and members of the dental team). Chapter 18 has described some of the specific problems with health care at the macro level. In this chapter we shall also look at some of the problems with how health care is delivered and problems with health services at the level of the user and the provider of health care. What should good health care look like? Maxwell (1984) defined six characteristics of a high-quality health care. Services should to be equitable (fair), accessible, relevant to health care needs, effective, efficient, and socially acceptable. There are recognized inequities in how health care is distributed; urban areas are often better provided for compared to rural areas, and hospital-based health care consumes more resources than community-based care. Not everyone has equal access to health care; for example, people living in deprived communities with greater health need have fewer doctors and dentists compared to richer areas with fewer health care needs. This phenomenon has been described as the inverse care law (Tudor Hart 1971). Uncomfortable choices and rationing have to take place in allocating health care resources. Ideally, these decisions should be based on the greatest health need (and the capacity to benefit) rather than who has the loudest voice. The focus on treatment inherent in the medical model of health means that resources are spent on high-technology medicine and hospitals, while programmes to prevent disease are poorly supported and resourced. There is an expectation that there will be a magic bullet for every health problem, yet most chronic diseases have no cure. People learn to adapt and cope with their chronic illness rather than recover.