Cohen A H, Cohen R, Taylor B R, Reznick R K
Department of Medicine, University of Toronto, Ontario.
World J Surg. 1994 Sep-Oct;18(5):672-5; discussion 671. doi: 10.1007/BF00298897.
Over the past three decades Canada has developed an exemplary system of universal health care. However, current financial constraints threaten to undermine the very foundation of the system that represents Canada's respect for social justice. The first of these two articles (Part 1) discusses the unique characteristics of the system, a comparative view of universal health care systems, the reaction of the medical profession to governmental control, and finally the funding and manpower shortages that are compelling a review of the values and organization that have sustained the system thus far. The second article (Part 2) reviews the organization and funding of medical education and the impact of some critical changes in the health care system on postgraduate medical education. Issues related to new licensure and certification requirements, changing population demographics and approaches to health care delivery, manpower needs, and the attitude and expectations of the public are discussed.
在过去三十年里，加拿大建立了堪称典范的全民医疗保健体系。然而，当前的财政限制有可能破坏该体系的根基，而这一体系体现了加拿大对社会正义的尊重。这两篇文章的第一篇（第1部分）讨论了该体系的独特特征、全民医疗保健体系的比较视角、医学界对政府管控的反应，最后还探讨了资金和人力短缺问题，这些问题促使人们重新审视迄今为止维持该体系的价值观和组织架构。第二篇文章（第2部分）回顾了医学教育的组织与资金状况，以及医疗保健体系中的一些关键变化对研究生医学教育的影响。文中讨论了与新的执照颁发和认证要求、不断变化的人口结构与医疗服务提供方式、人力需求以及公众的态度和期望相关的问题。
