International Journal of Health Policy and Management

International Journal of Health Policy and Management

Separated at Birth: The Politics of Pharmacare for All in Canada and Medicare for All in the United States; Comment on “Universal Pharmacare in Canada”

Document Type : Commentary

Author
Carolyn Hughes Tuohy
Munk School of Global Affairs and Public Policy, University of Toronto, Toronto, ON, Canada
10.34172/ijhpm.2020.31
Abstract
Policy decisions about healthcare coverage in Canada and the United States in the 1960s placed two virtually identical systems on different evolutionary paths in the physician and hospital sectors. However, prescription drug coverage remained outside Canada’s single-payer model, and employer-based coverage continued to be the norm for the workforce population, as is the case across the broad healthcare system in the United States. As a result the current debate about pharmacare in Canada mirrors in political microcosm the larger debate on universal health insurance among American Democrats. In each case the near-term prospects for a single-payer plan appear slim.
Keywords
Healthcare Politics
Universal Pharmacare
Medicare for All
Canada
United States
  1. Hajizadeh M, Edmonds S. Universal pharmacare in Canada: a prescription for equity in healthcare. Int J Health Policy Manag. 2020;9(3):91-95. doi:10.15171/ijhpm.2019.93
  2. Lewis S. It won’t be easy: how to make universal pharmacare work in Canada. Int J Health Policy Manag. 2020;9(1):1-5. doi:10.15171/ijhpm.2019.82
  3. Tuohy CH. Icon and taboo: single-payer politics in Canada and the US. Journal of International and Comparative Social Policy. 2019;35(1):5-24. doi:10.1080/21699763.2018.1550010
  4. Maioni A. Parting at the Crossroads: The Emergence of Health Insurance in the United States and Canada. Princeton, NJ: Princeton University Press; 1998.
  5. Hurley JE, Guindon GE. Private Health Insurance in Canada. Hamilton, Canada: Centre for Health Economics and Policy Analysis, McMaster University; 2008.
  6. Fronstin P. Sources of Health Insurance and Characteristics of the Uninsured: Analysis of the March 2005 Current Population Survey. Washington, DC: Employee Benefit Research Institute (EBRI); 2005.
  7. Canadian Institute for Health Information (CIHI). Drug Spending at a Glance. CIHI; 2018. https://www.cihi.ca/sites/default/files/rot/rot-document/nhex-drug-infosheet-2018-en-web.pdf.  
  8. Centers for Medicare and Medicaid Services. National Health Expenditures by type of service and source of funds, CY 1960-2018. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.
  9. Health Canada. A Prescription for Canada: Achieving Pharmacare for All: Final Report of the Advisory Council on the Implementation of National Pharmacare. Ottawa, Ontario: Health Canada; 2019. https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/implementation-national-pharmacare/final-report.html.  
  10. Soroka SN. Canadian Perceptions of the Health Care System: A Report to the Health Council of Canada. Ottawa: Health Council of Canada; 2007.
  11. Angus Reid Institute. Prescription Drug Access and Affordability an Issue for Nearly A Quarter of All Canadian Households. Vancouver: Angus Reid Institute; 2015. http://angusreid.org/prescription-drugs-canada/.
  12. Norton M, DiJulio B, Brodie M. Medicare and Medicaid at 50. Kaiser Family Foundation; 2015. https://www.kff.org/medicaid/poll-finding/medicare-and-medicaid-at-50/.
  13. Hamel L, Wu B, Brodie M. Data Note: Modestly Strong but Malleable Support for Single-Payer Health Care. Kaiser Family Foundation; 2017. https://www.kff.org/health-reform/poll-finding/data-note-modestly-strong-but-malleable-support-for-single-payer-health-care/.
  14. Kaiser Family Foundation (KFF). Public Opinion on Single-Payer, National Health Plans, and Expanding Access to Medicare Coverage. https://www.kff.org/slideshow/public-opinion-on-single-payer-national-health-plans-and-expanding-access-to-medicare-coverage/. Published 2019.
  15. Shapiro RY, Jacobs LR. Simulating representation: elite mobilization and political power in health care reform. Forum. 210;8(1). doi:10.2202/1540-8884.1360
  16. Quirk Paul J. Politicians do pander: mass opinion, polarization, and law making. Forum. 2010;7(4). doi:10.2202/1540-8884.1343
  17. Morone JA. How to think about “Medicare for All.” N Engl J Med. 2017;377(23):2209-2211. doi:10.1056/NEJMp1713510
  18. Nadeau R, Bélanger É, Pétry F, Soroka SN, Maioni A. Health Care Policy and Opinion in the United States and Canada. New York: Routledge; 2014.
  19. Tuohy CH. Remaking Policy: Scale, Pace and Political Strategy in Health Care Reform. Toronto: University of Toronto Press; 2018.
International Journal of Health Policy and Management
Volume 10, Issue 3
March 2021
Pages 162-164

  • Received Date 01 January 2020
  • Revised Date 23 February 2020
  • Accepted Date 25 February 2020
  • First Published Date 01 March 2021
  • Published Date 01 March 2021