Sunday, December 6, 2009

Historical contingency: Health care in Canada and the U.S.A.

An article in Sunday's Oregonian comparing the Canadian and U.S. health care systems asserts "Lessons for Us: More Equity and Efficiency." Among these lessons are that

"most Canadians have a basic belief in equality and, more importantly, their government and social support systems reflect that belief. On the other hand, Americans are more concerned about individual rights. In the United States, government and social support systems are often seen as necessary evils."

These identifiable national beliefs about health care in the U.S. and Canada were not handed-down from an omnipotent being, and are not immutable. They are the result of particular historical events. The article cited above outlines the history of the passage of The Canada Health Act (1984). In brief outline, Canada's current system evolved from a province-level initiative spurred by social justice concerns.

The current U.S. health care system happened by accident: "the Great Depression inadvertently inspired the spread of employer-based health insurance, World War II accidentally spread the idea everywhere."

According to the Oregonian article authors, the lessons to be gained from Canada's health care system are: 1) Spend less on administrative costs; 2) Negotiate lower prices for health services; 3) Cover everyone, all the time; 4) Ration health care based on need, not income.


1 comment:

  1. Jill Lepore finds that the health care debate in the U.S. goes back to the 190s, at least.