I read an interesting article from the journal Comparative Politics today. The article, entitled "Parting at the Crossroads: The Development of Health Insurance in Canada and the United States, 1940-1965", dissected the development of our current healthcare system between said years. These 15 years were crucial in the founding of healthcare in the United States and Canada. Antonia Maioni, the author, writes about some interesting facts and findings. The most striking difference I noticed was this: When the proposal for some type of national health insurance was proposed in Canada, there had already been an experiment of the sort in one of the provinces. In Saskatchewan, as Maioni mentions,
"A medical program that combined private fee-for-service delivery with public administration and financing was introduced in 1961..."In the United States on the other hand had no Saskatchewan, as Maioni concludes,
"The Saskatchewan experiments established the principles of universal health insurance, tested the limits of reform opponents, and ultimately demonstrated the success and shortcomings of such programs...In the United States there were few state-level initiatives in health insurance..."This finding was still relevant until very recently. States have recently began to take the initiative in the road to universal coverage. Massachusetts's reform is right now the most provincial experiment so far, but many other states are trying to do the same. Now the only problem for states in experimenting is getting around the Employee Retirement Income Security Act or ERISA, which
"shields businesses from state and local regulation of the benefits they offer workers, including health insurance. Without the law, national companies in particular could achieve little uniformity in their benefit plans."You can find an explanation of the ERISA problem here.
