Caring for the Uninsured and Underinsured

Abstract

To the Editor. — Bronow et al 1 justify their complex proposal for health care reform on the basis of their perception of the Canadian system. Their views of the Canadian situation, particularly in relation to the largest province, Ontario, are selective and have been overtaken by changes in the past year. It is no longer the case that relations between the Ontario Medical Association (OMA) and the government are at an all-time low. In September a majority, left-of-center New Democratic government was elected. In May 1991, an agreement was finalized establishing payment mechanisms, a joint committee to manage the health care system, and sole bargaining rights to the OMA. Bronow et al acknowledge that the Ontario system is already cheaper, more comprehensive, less bureaucratic, and has lower administrative costs than that in the United States. These strengths exist despite some past intrinsic weaknesses, which include a lack of rational