Canadians are justifiably proud of Medicare. This national (strictly, federalprovincial) program is not merely a mechanism for reimbursing hospital and physicians’ services. It is one of the (few) institutions expressing the unity and distinctness of the Canadian people, and our commitment to each other both symbolically and in hard cash. But in fact all (but one) of the major industrialized countries have established universal public payment systems for health care, and most are similarly proud, or at least highly supportive, of them. National systems differ in important details but in broad outline all share the characteristic features that White (1995:271) labelled the ‘International Standard’:

• universal coverage of the population, through compulsory participation; • comprehensiveness of principal benefits; • contributions based on income, rather than individual insurance purchases; • cost control through administrative mechanisms, including binding fee

schedules, global budgets, and limitations on system capacity.