One of the major goals of health reform is assuring financial access to a basic benefits package for all U.S. citizens, while maintaining better health at a contained rate of growth in costs. In questioning the ability of the Clinton Health Security Act to achieve this goal, the article presents a rationale for the consideration of those aspects of organizational reform that are necessary to achieve a primary care orientation that would meet such a goal. The author cautions that reform proposals that focus primarily on the financing of services are unlikely to influence the organizational reorientation from a specialty focus to a primary care imperative.