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HLST 1010 (139)
Chapter 11


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Health Studies
HLST 1010
Kenneth Lam

Chapter 11 - Evolution of Health Care Policy: Deconstructing DivergentApproaches *In exploring the important aspects of the divergent and convergent approaches that Canada and the US have adopted toward their health care sectors, we consider how the different political systems in each state have shaped its recent reconstructing efforts, and how international systems of care have informed the directions taken. Ideological Perspective Most countries have common goals regarding health care that include: - Social protection: Enable those with fewer resources to access health care - Redistribution: Redistribute health care costs among individuals, employers and society - Efficiency: Ensure efficiency in the production and consumption of health services Health Care - development and reform of national health care systems highly politicized and debated within each nation US Health Care - private health insurance - programs of public health insurance for people on social security (65+) - MEDICARE - MEDICAID - public health coverage for those on social assistance - The rest: private insurance - through employment, veteran affairs etc - **45 million uninsured, millions underinsured Canadian Health Care - Universal system of public health insurance, in which provincial public insurance plans develop contracts with nonprofit health care insitituations such as hospitals and health practitioners to deliver health care to the Canadian population Divide between: - liberalism and socialism - free market and planned economy Box 11.1 - Liberalism and Socialism - Liberalism comes from the word libre and emphasizes the following: - Personal freedom - absence of coercision; individuals can pursue their own interests - limited government: government acts only as an umpire to enforce the rules of society need to sustain a free market. Limits on government are defined in the constitution. - Equality of right: everybody must abide by the same rules. (Reform liberals redefined the notion of equality to equality of opportunity. Reform liberals consider the positive role of the state in promoting individuals potential) - Consent of the governed: elections - Alternatively, socialism is motivated by a dislike of the consequences of the market economy that are inherent in the liberal vision. Instead socialism: - Emphasizes assets are owned by the community, which benefits are distributed to all, not just select private owners. - Aspires to a higher degree of equality of results - works towards political gradualism. the goal is to make the state more politically accountable. Box 11.2: Market Failure:ARationale for Government Intervention Free Market: Liberal economists believe public welfare is promoted by a competitive market through the so- called inivisible hand: People’s utlility maximizing behavior and firms’profit-maximizing behavior will, through the “invisible hand,” lead to an optimal distribution of goods. But economic reality differs from the assumptions of the competitive model: Efficient outcomes are not always promoted by the market, leading to market failures, which provide the economic rationale for government intervention. The market fails for such public goods as: - primary and secondary education - health care Society benefits from an educated population whose health care needs are addressed. The market does not, however, distribute those on a universal basis, which provides the rationale for government involvement. Political Institutions and Historical Perspective: US - policy reforms, large process. Canada faces fewer obstacles pr. 290-291. 3 reasons. Chaoulli Case in Quebec - attempted to challenge the quebec legislation that prohibits private insurance for publ
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