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註釋This monograph first discusses the dangers of using aggregate numbers to reach any conclusion over the merit of spending more or less on health care in Canada. To support a hypothesis that the present health system does not incorporate the proper incentives, the pattern of spending at a major teaching hospital is used as an example. Chapter two describes three different systems that have made reforms involving some form of market mechanism. A made-in-Canada internal market reform is proposed that assures universality and public funding, with funding tied to the doctor and not a proposed TMA (targeted medical agency). Finally, the potential impact of this reform on hospital institutions is discussed.