Health care costs per head in the USA are three times higher than in the UK, yet overall the UK achieves better health outcomes. Recent British reforms have highlighted problems in the delivery of care due to resource allocation, while political imperatives in America have focused on spiralling costs. This work draws together international expertise to produce models of excellence for primary care, allowing current and future decision-makers and opinion-formers to learn from the best practices. In his capacity as WHO Consultant in Primary Care, John Fry spent decades studying the organization of primary care around the world. He laid the groundwork for this exhaustive examination of the US and UK systems, which brings together invaluable data demonstrating the varying effectiveness of current approaches. It provides an agenda for discussion and action aimed at strengthening primary care within all health systems.