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Book and Media Reviews
February 14, 2007

Health Systems in Transition: Canada

Author Affiliations

Book and Media Reviews Section Editor: John L. Zeller, MD, PhD, Fishbein Fellow, JAMA.

JAMA. 2007;297(6):644-648. doi:10.1001/jama.297.6.647

The Canadian health system is no stranger to even the most casual US observer of health policy. For years, we’ve compared ourselves to our northern neighbor, and they have done the same.

These comparisons are almost always hyperbolic. The Canadian system may not feature in the US health policy debate as frequently as it once did, but its positive aspects are still held up by single-payer health system advocates as an example to which we should aspire. In this vein, the Physicians for a National Health Program outlined their proposal for a single-payer US health system in JAMA,1 with frequent reference to the positive aspects of the Canadian system. At the other ideological pole, the Canadian system is frequently used to scare US residents with visions of waiting lists, rationing, and desperate Canadians flocking to US havens for needed medical care. Similarly, advocates for market-oriented reforms in Canada point to the availability of high-tech care in the United States. For most Canadians, though, the US health system serves as a boogeyman, an example of what can go wrong in health care, and a marker of the distinction between Canadian and American values.2

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