Canada's universal health insurrance system is designed to assure all Canadians access to free hospital and medical treatment. Each province has bad considerable latitude in administering the system within its borders. To cope with rising costs, most provinces have adopted policies that limit physician income. Others have instituted fees for service users and have allowed physicians to bill patients for charges above the benefit schedule set by the province. These latter practices have been seen as eroding access to health care, and government funding for provinces that permit them was sharply curtailed by the Canada Health Act of 1984. The law is currently being challenged by the Canadian Medical Association because of the restrictions it places on physicians' freedom of practice. Although the Canadian system has created problems for physicians, the authors believe it provides a benefit no one wants to lose: accessible medical care for all.