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December 3, 2003

Proposals for US National Health Insurance

JAMA. 2003;290(21):2797. doi:10.1001/jama.290.21.2797-a

In Reply: Dr Palmisano incorrectly equates our proposed NHI with Canada's. The United States spends 75% more per capita on health care than Canada and 145% more than Britain1; our higher spending would (and should) persist under NHI. Underfunding in Canada has caused some waits and shortages, which have been exaggerated in the US press.2 Nonetheless, levels of satisfaction with the Canadian health care system are similar to those in the United States.1,3 We believe that Canada spends too little on health care, but gets great value for money. While Canadians appropriately criticize their system, they overwhelmingly support it.4