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Washington, Ottawa, and health care reform: a tale of 2 capitals.

ENACTMENT OF HEALTH CARE REFORM 1 SETS THE UNITED States on a course for nearly universal health insurance coverage. While a remarkable and historically significant accomplishment, the legislation came within a hair’s breadth of failure. Even its passage places the country in a position similar to that achieved by Canada almost a half century ago. This article describes the principal reason for this time lag and comments on its implications.