To meet the health crisis that is already upon the United States, it is essential that rational planning be undertaken. With a conscious effort, the general health levels of our nation's poor can be raised to that of the general population, and our health resources can function at maximum efficiency. The first steps toward the formulation of a general health policy have been taken. But these steps, hardly confident paces, have faltered, bumping into barriers which spring from many sources. This comment is an attempt to describe the forces that create, forestall, dilute, and terminate health planning and to assess this planning in a limited context. The restraints on effective health planning are complex and difficult to identify. Little has been written, and consequently little is known, about planning legislation and agencies. More specifically, this paper attempts to identify the relevant planning legislation; to describe and analyze the planning process; and to suggest the legislation needed to make planning effective. If the poor are to receive the health care that all people, regardless of ability to pay, deserve and should receive, a basic reorientation in our thinking about health policy is necessary. Although this change may not come about in a systematic manner, it is useful to identify the deficiencies and strengths of the process that seeks to realize the ideal.