By Gerard W. Boychuk

After international warfare II, the USA and Canada, international locations that have been very related in lots of methods, struck out on extensively divergent paths to public medical health insurance. Canada constructed a common single-payer approach of nationwide healthiness care, whereas the USA opted for a twin method that mixes public medical insurance for low-income and senior citizens with deepest, essentially employer-provided medical insurance - or no coverage - for everybody else.In "National medical health insurance within the usa and Canada", Gerard W. Boychuk probes the old improvement of health and wellbeing care in each one kingdom, honing in at the so much designated social and political facets of every state - the politics of race within the U.S. and territorial politics in Canada specifically the tensions among the nationwide govt and the province of Quebec. as well as the politics of race and territory, Boychuk sifts in the course of the quite a few elements shaping wellbeing and fitness coverage, together with nationwide values, political tradition and associations, the facility of certain pursuits, and the effect of strategic offerings made at severe junctures. Drawing on old documents, oral histories, and public opinion information, he offers a nuanced and considerate research of the evolution of the 2 platforms, compares them as they exist this day, and displays on how every one is poised to fulfill the demanding situations of the long run.

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Additional info for National Health Insurance in the United States and Canada: Race, Territory, and the Roots of Difference (American Governance and Public Policy)

Sample text

Canada is also marked by sharp economic tensions among various regions, which also reinforce territorial divisions. Two types of interregional economic tensions exist. First, there are inherent tensions between provinces whose economies rely primarily on an industrial base (especially Ontario and Que´bec) and provinces whose economies rely primarily on natural resource extraction such as petroleum (Alberta), agriculture (Saskatchewan), and fishing and forestry (Atlantic Canada). 4 These territorially based axes of political conflict have been reinforced by existing institutions—especially Canadian federalism.

8 Primary jurisdiction over health care was granted to the provinces by S. ’’ The federal government has involved itself in the provision of health care, however, primarily through the use of the federal spending power. This power, which is not explicitly established in the Canadian constitution but has recently been recognized by the federal and provincial governments under the Social Union Framework Agreement of 1999, allows the federal government to make transfers to the provinces attaching whatever conditions it wishes so long as it does not undertake to legislate directly within a field of provincial jurisdiction.

In the postwar period, federal policymakers recognized national social programs as potentially potent tools to defend against these territorial challenges—a point of which provincial officials were also highly cognizant. In the context of welfare state expansion, a dynamic of competitive state-building, in which the different orders of government compete vigorously to occupy political and policy space, would come to dominate. Banting explains why: Social programs controlled by the central government can become instruments of nation building, helping to mediate regional tensions and strengthen the state against centrifugal forces rooted in territorial politics.

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