TORONTO — For Dr. Peter Cram, an American internist who spentmost of his career practicing in Iowa City, Iowa, moving here aboutfour years ago was almost a no-brainer.

He’s part of a small cohort of American doctors who, forpersonal or professional reasons, have moved north to practice inCanada’s single-payer system. Now when hesees patients, he doesn’t worry about whether they can afford treatment. He knows “everyone gets abasic level of care,” so he focuses less on their finances and moreon actual medical needs.

Cram treats his move as a sort of life-size experiment. As aU.S.-trained physician and a health system researcher, he is nowstudying what he says is still a little-understood question: How dothe United States and Canada — neighbors with vastly differenthealth systems — compare in terms of actual results? Does one do a better job ofkeeping people healthy?

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