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Chapter 11
Ch.11 – Evolution of Health Care Policy: Deconstructing Divergent Approaches

This chapter discusses the political and economic aspects that have taken both Canada and the US in different paths which is ultimately shaped by the organization and delivery of care with its recent restructuring efforts. The US health care system is a system of private health insurance where most of the population gets benefits through employment or other benefit plans such as those for veterans. There is public health insurance for those on social security called Medicare and those that require social assistance called Medicaid. But, 45 million people are still uninsured and millions are underinsured. Unlike the US, Canada has a universal system of public health insurance where contracts with private non-profit health care institutions such as hospitals and health practitioners deliver care. The national health insurance represents a sense of clarity between “free market” liberalism and the “planned economy” socialism. Public financing is considered the optimal form of health care financing due to the fact that insurance is affordable to all citizens no matter how ill, effective cost control over health care services, and there’s universal coverage. With such a system, those that are healthy that do not need many treatments support those that require health care service which ultimately offer good cost control and good equity. Canada and the US have different perspectives in access to their pharmaceuticals. Canada has a public health insurance where people over the age of 65 and those on social assistance are covered. Unlike Quebec that has a drug benefit program for everyone, Ontario has created programs to those that have a large amount of drug costs and the rest of the population has access through private insurance through employment. This causes issues with those that are in low paying or have part-time jobs. Pharmaceuticals here in Canada are regulated by the Patented Medicines

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