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A comparative study of health care policy in the United States and Canada: what policymakers in Latin America might and might not learn from their neighbors to the North

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  • White, Joseph B.
Abstract
The purpose of this comparative study of the structure and operation of the health care systems in the United Stetes and Canada is to draw lessons from those experiences that may be relevant to the countries of Latin America and the Caribbean. First, the study examines the different sources of health-sector funding in the United States and Canada and the levels and types of coverage provided. The fact is brought out that per capita levels of expenditure in these two countries exceed per capita national income in much of the region. A comparison of the two systems shows that, although expenditure is lower in Canada, its coverage is better. Second, the author discusses the different methods of payment that have been implemented in conjunction with regulatory and supervisory instruments and institutions. In Canada, responsability for health-budget performance lies with the provinces, and transfers from the central government are made, inter alia, through a capitated payments sys tem. In the United States, a number of different payers, each with its own individual cost control mechanims, are found. It is argued that selective outsourcing of health-care services in the United States would appear to be less relevant for Latin American countries than the Canadian system of payment, given the need to increase the levels of coverage in these countries. Third, the study focuses on proposed health care reforms in the two countries. One of the main objectives of these reforms is to curb rising costs. Lastly, the author draws a number of conclusions which he considers relevant to the needs of Latin American and Caribbean countries. The assertion is made that the Canadian system offers advantages in terms of the provision of affordable health insurance for all.

Suggested Citation

  • White, Joseph B., 1997. "A comparative study of health care policy in the United States and Canada: what policymakers in Latin America might and might not learn from their neighbors to the North," Financiamiento para el Desarrollo 5256, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    • Handle: RePEc:ecr:col035:5256
    Note: Includes bibliography
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    File URL: http://repositorio.cepal.org/handle/11362/5256
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    Cited by:

    1. Fox, M. Louise & Palmer, Edward, 2001. "Pension reform in Europe in the 90's and lessons for Latin America," Financiamiento para el Desarrollo 5092, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    2. Guillermo Cruces & Quentin Wodon, 2007. "Risk-adjusted poverty in Argentina: measurement and determinants," Journal of Development Studies, Taylor & Francis Journals, vol. 43(7), pages 1189-1214.
    3. Sojo, Ana, 1998. "Health management contracts in Costa Rica from a comparative perspective," Revista CEPAL, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL), December.
    4. Cruces, Guillermo & Galiani, Sebastian, 2007. "Fertility and female labor supply in Latin America: New causal evidence," Labour Economics, Elsevier, vol. 14(3), pages 565-573, June.
    5. Palmer, Edward, 2006. "Public policy for pensions, health and sickness insurance: potential lessons from Sweden for Latin America," Financiamiento para el Desarrollo 5156, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    6. Macedo, Roberto B.M., 2003. "Macroeconomic volatility and social vulnerability in Brazil: the Cardoso government (1995-2002) and perspectives," Financiamiento para el Desarrollo 5113, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    7. Willmore, Larry, 2006. "Non-contributory pensions: Bolivia and Antigua in an international context," Financiamiento para el Desarrollo 5145, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    8. José Antonio Ocampo & Camilo Ernesto Tovar, 1999. "Price-based capital account regulations: the Colombian experience," Documentos de Investigación 3372, Cepal Naciones Unidas.
    9. Titelman Kardonsky, Daniel & Calcagno, Alfredo Fernando & Manuelito, Sandra, 2003. "From hard-peg to hard landing?: recent experiences of Argentina and Ecuador," Financiamiento para el Desarrollo 5106, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    10. Paddison, Oliver, 2006. "Social security in the english-speaking Caribbean," Financiamiento para el Desarrollo 5152, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).

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