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A Look Across a Frontier

J. Grimley Evans, MD, FRCP, FFPHM

JAMA. 1996;275(18):1449-1450.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The United States and Canada are 2 federal nations separated geographically by an arbitrary line of latitude but culturally by 200 years of history. The ancestry of their institutions lies respectively, albeit remotely, in the anarchy of frontiers and the order of empire. Different assumptions about the natural way to organize society emerge in the pattern of their health services. The United States presents to the world a vision of rampant entrepreneurialism bridled by the enlightened self-interest of citizens and spurred by sporadic pricks of compassion. Canada's more collectivist tradition emerges in a concern that its health services should make sense in the context of equity and the public health, an ideal that has yet to be fully realized.¹ It has, however, retained the tradition of the physician as a fee-paid professional, and only in the salaried medical staff of some primary health care centers in Quebec does one . . . [Full Text PDF of this Article]

Author Affiliations
From the Division of Clinical Geratology, Nuffield Department of Clinical Medicine, University of Oxford, Radcliffe Infirmary, Oxford, England.

Footnotes
Corresponding author: J. Grimley Evans, MD, FRCP, FFPHM, Department of Clinical Geratology, Radcliffe Infirmary, Oxford OX2 6HE, England.

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