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The key issues facing the Ontario health-care delivery system are outlined in this note: declining dollars in the hospital sector, funding formulas and how funding is from both government and private sector, the key policy issues facing the sector, the lack of integration in the delivery system, the impact of changing demographics, likely changes in the system, and the key role played by primary physicians in the system. The note provides a necessary background to a series of health care-related cases. Examples include: St Catharines General Hospital ''9A98B006'' and Markham Stouffville Hospital ''9A99B005''. A strong understanding of the issues and infrastructure of the system will result from the use of this note.