This paper was commissioned by the Royal Commission on Aboriginal Peoples to provide a summary of the proceedings of the National Round Table on Aboriginal Health and Social Issues, held in Vancouver March 10-12, 1993. Portions of this summary were provided to participants at the Round Table in an oral presentation at the end of the conference. Ideas first presented there have been developed further in this paper. A draft of this paper was circulated to the Commission Co-Chairs and others involved in organizing the Round Table, and their comments have been incorporated.