As almost all newspaper or magazine readers know, Canada figured prominently in the turbulent U.S. debates over health care reform in the early Clinton presidency. Furthermore, future news analysts and policymakers will undoubtedly again use Canada to cite the "good" and the "bad" aspects of single-payer national health insurance. Beyond the debate about the desirability of Canadian-style health care reforms, Antonia Maioni sees another question: Why did the United States and Canada, alike in so many ways, part "at the crossroads" to produce such different systems of health insurance? She answers this previously neglected query so interestingly that her book will hold the attention of anyone concerned with health care in either country or both.
The author explores the development of health insurance in the United States and Canada, from the emergence of health care as a political issue in the 1930s to the passage of federal health insurance legislation in the 1960s. Focusing on how political institutions influence policy development, she shows that Canada's federal structure and its parliamentary institutions encouraged a social-democratic third party that became pivotal in demonstrating the feasibility of universal, public health insurance. Meanwhile, the constraints of the U.S. political system forced health care reformers to temper their own ideas to appeal to a wide coalition within the Democratic party. Even readers previously unfamiliar with Canadian politics will find in this book important clues about the "realm of the possible" in the uncertain future of U.S. health care.
Table of Contents:
List of Abbreviations
Ch. 1 The United States and Canada in Comparative Context 3
Ch. 2 Parties and Institutions in Health Politics 14
Ch. 3 The 1930s: Early Impasse in Health Reform 32
Ch. 4 The 1940s: False Starts and Failures of Postwar Health Insurance Proposals 66
Ch. 5 The 1950s: Diverging Paths to Health Reform 92
Ch. 6 The 1960s: The Political Battle for Health Insurance 119
Ch. 7 Why Did They Part? Explaining Health Policy Trajectories in the United States and Canada 153
Ch. 8 Point of No Return? Policy Legacies and the Politics of Health Reform 166