An analysis of more than two decades of poll results has identified six major trends in public opinion likely to affect the health care system of the 1990s. Americans favor more rather than less health spending, at least as long as the economy remains strong, and they do not think the deficit problem requires cuts in medical care outlays. Should there be a serious economic downturn, however, the public would reverse itself and would favor reduced spending that relies on a different set of strategies than those favored by most health policy experts, particularly in regard to spending for care for the elderly. In either case, the poll results suggest that Americans may be less inclined to participate in newer forms of medical practice, such as health maintenance organizations or preferred provider organizations, than anticipated, and that the commercialization of health care is leading to a decline in public confidence in the leaders of medicine. This latter trend may result in a lack of trust in professionals' views concerning the quality of care and may presage more stringent government involvement in and regulation of health services.