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August 19, 1998

Hospital Services in the United States and Canada—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(7):599-600. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-7-jbk0819-e

In Reply.—Dr Aitken argues that delays in Canada could be reduced by policies that would allow patients to pay out-of-pocket. When hospital services are purchased, however, our analysis suggests that higher charges in the United States do not always bring faster care. This is surprising, given that the United States has a dominant market culture and a sophisticated consumer population and higher prices usually bring quicker service. We know of no data to suggest a market system would be more successful in Canada.

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