<<Name>>
<<Professor Name>>
<<Subject>>
<<Date>>
The paper on Comparative Politics by Maioni, A. (1997, pp. 411-431) makes a comparison between the evolution of the health care systems in two neighboring countries – Canada and the U.S.A. The crux of the argument and facts presented are based on the differences in the governance and political systems of the two countries.
The paper tends to argue the facts around the post-depression period of the 1930s and the 1940s where both the countries faced different paths with regard to health care reform. Maioni (1997) argues that the countries went their separate paths on their health care systems primarily due to their differences in the partisan politics of the two countries.
The article deals with the social, political and institutional factors that led to the two countries adopting different approaches to health care. Though both the countries are liberal democracies with good governance systems and a welfare state, it cites the case of Canada where the emergence of a third party in the political milieu led to the implementation of public and universal health care.
The article cites the basic differences in Canadian and U.S. systems, which enable Canada to have a third party in the opposition. This is not possible in the U.S. system due to structural barriers in the electoral system. This third party holds a balance of power and can influence government regulation and policy in Canada. This is however not possible in the U.S.A. style of government. It cites the rise of the Co-operative Commonwealth Federation (CCF – a third party in Canada) as the primary reason or influence that paved the way towards universal health.
In contrast the American health care system evolved in the 1940s but did not receive the support of President Roosevelt. The American plan was to follow a more targeted approach with poor and elderly as primary beneficiaries of the plan. This was initiated under President Truman.
Although the article gives a comparative history of how the systems evolved in both the countries, it does not prove to be a cause and effect scenario. In the case of Canada for example, the rise of the CCF was due to their election plank or promise which was based on health care for all. Any party in the parliamentary democracy could have adopted universal health care as a plank for election.
The historical comparison is also not valid since in the case of Canada, the powerful body of medical institutes, practitioners and businesses were institutionalized by government regulation and with strong public opinion favoring the CCF. This could have happened even in the U.S.A, if one of the primary parties – either the conservatives or liberals had adopted universal health care as a key policy and an election plank.
The U.S. followed a more targeted approach with labor unions agreeing to a voluntary insurance rather than social medicine. This meant that the two parties had to build a consensus along with the medical practitioners, insurance industry and other bodies. Though there are many pressure points in Canada between the government and the medical system, there is some sort of consensus that has been built. This does not mean however, that it was due to the emergence of the third party system alone. In the absence of CCF, another form of health care reform would have probably emerged in Canada which was favorable to all the stakeholders.
In the United States, the health care system has been a victim of politics and controversy with not much of a consensus on the right approach. However this is not due to its dual party system. It has its roots in the complex relationships and development of a capitalist society versus a social welfare state.
The key learning from the article is that the influence of powerful political lobbies and the business interests will continue to exist until a favorable, integrated health care reform policy is implemented, that is agreeable to all and beneficial to the citizens of Canada and the U.S.
References
Maioni, Antonia. “Parting at the Crossroads: The Development of Health Insurance in Canada
and the United States.” Comparative Politics, vol. 29, no. 4, 1997, pp. 411-431.
