National Health Insurance in the United States and Canada

National Health Insurance in the United States and Canada: Race, Territory, and the Roots of Difference (American Governance and Public Policy) by Gerard W. Boychuk

This work is intended to develop the argument that the politics of race in the United States and the politics of territorial integration in Canada together provide a powerful explanation of the divergent historical development of public health insurance in the two countries. This alternative interpretation is intended as a second opinion offered in contrast to more conventional wisdoms in each country. There is a widespread perception that health care systems in the United States and Canada present a stark contrast to each other. Differences in public health care, however, in the United States and Canada as well as the roots of these differences are more subtle and complex than generally recognized in academic policy analysis and popular debates. These differences, often exaggerated, caricaturized, and simplified, are widely believed to be rooted in fundamental differences in national values or political culture. The American system of targeted public health care and greater reliance on private provision of health care is often seen as evidence of the stronger influence in America of individualism and belief in a limited role for the state. Canada’s universal public health care system is often taken as evidence of a greater Canadian predisposition toward collective provision of social well-being and acceptance of a greater role for the state. Alternatively, these differences are sometimes seen as the result of the institutional distinctiveness of the political systems of the two countries—the fragmentation of power inherent in the American ‘‘separation of powers’’ system vs. the relative concentration of power in the Canadian parliamentary system. These institutional differences are in turn usually explained as being rooted in divergent perceptions about the appropriate role of the state in each country. Finally, differences in public health insurance in the United States and Canada are sometimes explained as the result of path-dependent processes— hinging on earlier differences in the sequence and timing of the development of public health insurance, especially the development of private health benefits.

Contents of "National Health Insurance in the United States and Canada"

1. introduction: Explaining Health Insurance in the United States
2. Public Health Insurance in the United States
3. Public Health Insurance in Canada:
4. Conclusions: Contemporary Public Health Insurance in the United States and Canada.

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