Dr Figurski says that I suggest imposing financial barriers that would delay treatment and impose suffering on patients. I do nothing of the sort. I propose offering affluent patients expedited service for an additional fee that will be specifically applied to providing services for patients with lesser means. This is the fundamental basis of a progressive taxation system. The net result will be additional capacity and shorter waiting lists for procedures undersupplied by the public health care system. The approach is ethically sound and improves the well-being of all patients compared with the status quo. With competition, market forces will indeed come to bear. For the system, private facilities may increase efficiency. For patients, as the service in economy class gets faster, fewer will choose to fly first class.
Dr Figurski seemingly defends and derides the Canada Health Act, yet does not appear to understand the conflict with the Charter of Rights and Freedoms that engendered my suggestion in the first place. The Supreme Court has not doubled down on the Canada Health Act: it has declared it unconstitutional. Free health care is not enshrined in the Charter. As the growing myriad of current violations demonstrate, the Canada Health Act is on life support. Some would happily see it die; however, I believe that most Canadians would prefer a measured compromise to the Wild West of unregulated private health care.
—Andrew Kotaska, MD
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
- Only the first three authors are listed, followed by "et al."
- There is no period after the journal name.
- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org