The article by Rosser and Kasperski, "Organizing Primary Care for an Integrated System," provides an important stimulus for examining issues surrounding healthcare reform in Canada. As the "Guidelines for Commentary" of HealthcarePapers indicate, healthy debate can foster "constructive change." The Canadian Nurses Association welcomes the opportunity to engage in such a debate and it is within this spirit that we offer a number of challenges, both at a theoretical/conceptual as well as a factual level, to the ideas presented by Rosser and Kasperski. Although there are a number of points in the article that warrant attention, this commentary will address only a selected few.