sures, ranks far behind that of Canada (Janigan, 1995).
The Canadian single-payer system was developed gradually over the last three decades, with the linchpin of the federal system being the Canada Health Act, passed in 1984. The Canada Health Act established the universal coverage system, defined basic health care standards, and provided for transfers of funds to the provinces in accordance with their conformance to the national system (Janigan, 1995). Thus, all Canadian citizens, including new immigrants, have access to basic health care services at all times, simply by using their national health card.
It is in this actual receipt of health care services where Canadians claim a clear advantage over their U.S. counterparts. While the U.S. may offer more choices, more high technology, and more potential health care services, the Canadian system provides both universal access and delivery of health care services.
In actuality, however, as budgets are cut in Canada, accessibility to certain kinds of procedures diminish because provinces and individual hospitals are forced to place a ceiling on the number of particular procedures that can be performed each year. For example, a patient may not be able to obtain needed cataract surgery, even though this is covered under the health care plan, because the budget will simply not allow for that to occur. Patients already wait many months for certain medically necessary procedures. Evans (1994) made the point that there is a tendency in such systems to discriminate against certain populations, particularly the elderly who need more health care procedures more frequently. If there are only limited resources available, and these resources are not sufficient to meet the demand, then rationing of medical care, waiting lists, and other kinds of management procedures actually result in a reduction in accessibility to services.
In the U.S., one of the focal points in the latest he...