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May 26, 2010

Washington, Ottawa, and Health Care Reform: A Tale of 2 Capitals

Author Affiliations

Author Affiliations: Department of Psychiatry and Biobehavioral Sciences, and LABiomed, Harbor-UCLA Medical Center, Torrance, California (Dr Sessions); Departments of Health Policy Management and Evaluation and Medicine, University of Toronto, Department of Medicine, Mount Sinai Hospital, and University Health Network, Toronto, Ontario, Canada (Dr Detsky).

JAMA. 2010;303(20):2078-2079. doi:10.1001/jama.2010.654

Enactment of health care reform1 sets the United States on a course for nearly universal health insurance coverage. While a remarkable and historically significant accomplishment, the legislation came within a hair's breadth of failure. Even its passage places the country in a position similar to that achieved by Canada almost a half century ago. This article describes the principal reason for this time lag and comments on its implications.