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Invited Commentary
Health Care Reform
September 2018

Drawing Lessons From Canada’s Experience With Single-Payer Health Insurance

Author Affiliations
  • 1Department of Political Science, Case Western Reserve University, Cleveland, Ohio
  • 2Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
JAMA Intern Med. 2018;178(9):1255-1257. doi:10.1001/jamainternmed.2018.3707

In this issue of JAMA Internal Medicine, Ivers et al1 discuss the course of Canada’s “single-payer” (or “Medicare for all”) health insurance system over the last 50 years. The article summarizes the reasons why the Canadian system can seem superior to the insurance system in the United States. Awareness of those differences is one reason why Canadians are especially wary of change; it takes little imagination for them to envision the universal coverage and other features that they could lose. The article also highlights the ways in which the Canadian system is by no means ideal—especially public concerns about constrained access to some medical care and the lack of universal coverage for pharmaceuticals. In the mid-1990s, worries about delayed access to care increased substantially in Canada and were accompanied by decreasing public satisfaction with the system.

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