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Raisa Berlin Deber, PhD

The author is with the Department of Health Policy, Management, and Evaluation, University of Toronto, Ontario.

Correspondence: Requests for reprints should be sent to Raisa B. Deber, PhD, Department of Health Policy, Management, and Evaluation, 12 Queens Park Crescent W, 2nd Floor, Toronto, Ontario M5S 1A8, Canada (e-mail: raisa.deber{at}utoronto.ca).

Although Canadian health care seems to be perennially in crisis, access, quality, and satisfaction in Canada are relatively high, and spending is relatively well controlled. The Canadian model is built on a recognition of the limits of markets in distributing medically necessary care.

Current issues in financing and delivering health care in Canada deserve attention. Key dilemmas include intergovernmental disputes between the federal and provincial levels of government and determining how to organize care, what to pay for (comprehensiveness), and what incentive structures to put in place for payment.

Lessons for the United States include the importance of universal coverage, the advantages of a single payer, and the fact that systems can be organized on a subnational basis.

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