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While there are broad differences between the health-care systems in Canada and the United States, sub-national variation is significant in both countries (though more notably among American states), both in terms of the role of government in the provision of health-care as well as outputs of the health-care system such as access and cost-control. Although this variation is rarely considered in comparisons of health-care policy in the two countries, the value of using the United States as a comparative reference in contemporary policy debates in Canada would be considerably greater if such variations were utilized to augment the analytical leverage resulting from such comparisons. [ABSTRACT FROM AUTHOR]