National Health Insurance and Health-Based Drug Policy: An Examination of Policy Linkages in the USA and Canada

2004 ◽  
Vol 33 (1) ◽  
pp. 133-151
Author(s):  
ELLEN BENOIT
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Drug Policy ◽  
Addiction Treatment ◽  
Universal Access ◽  
Public Health Problem ◽  
The United States ◽  
The Usa

For more than 50 years the United States and Canada maintained illegal-drug policies that followed the same course: a long period of punitive prohibition followed by moderation and an emphasis on drug abuse as a public health problem. Then in the 1980s, the USA reverted to a punitive model while Canada increased its commitment to a health-based approach. Why this divergence after following the same path for so long? In this paper I argue that one factor was Canada's adoption of national health insurance, which guaranteed universal access to health care, including addiction treatment. As the country's most popular policy it was protected against budget cuts during a period of welfare-state retrenchment in the 1980s. In the USA, on the other hand, public health insurance was limited to the elderly and the poor, and addiction treatment services were isolated and stigmatized. Thus the public health side of drug policy was poorly positioned to resist welfare cutbacks and ascendant criminal-justice interests. The experiences of the USA and Canada have implications for policy reformers and for the study of how institutional interests cross policy domains.

scholarly journals Rates and characteristics of lower limb amputations in Taiwan, 1997

2002 ◽  
Vol 26 (1) ◽  
pp. 7-14 ◽  
Author(s):  
S. Y. Chen ◽  
W. C. Chie ◽  
C. Lan ◽  
M. C. Lin ◽  
J. S. Lai ◽  
...  
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Lower Limb ◽  
The United States ◽  
Research Database ◽  
The United Kingdom ◽  
Female Rate ◽  
Insurance Programme ◽  
National Health Insurance Programme

This study aims to describe the national incidence rate and characteristics of lower limb amputations (LLA) in 1997 from an island-wide database of the national health insurance programme in Taiwan. Some 117,647 discharge records from a sampled database (1 in 20) of the National Health Insurance Research Database were analysed. This study included records (n=171) containing LLA procedures. The LLA procedure rates were obtained by multiplying the number of identified procedures by 20 as the numerator and mid-year total population of Taiwan in 1997 as the denominator. Each procedure was further analysed according to the demographic characteristics of the patients, cause and level of amputation. Summarised gender ratios of LLA procedure rates were obtained by Poisson regression analysis. The crude LLA procedure rate was 18.1 per 100,000 population per year and the crude major LLA procedure rate was 8.8 per 100,000 population per year in Taiwan in 1997. The major cause of LLA procedures was peripheral vascular disease (72%), and the toe was most frequently amputated (48%). The LLA procedure rates, which increased logarithmically with age of patients, were significantly higher in men with a summarised male to female rate ratio of 1.65. The age-standardised LLA procedure rate in Taiwan was lower than that reported in the United States, Finland, the Netherlands, the United Kingdom (Leeds, Middlesborough, and Newcastle), but higher than Spain, Italy, and Japan. The trend of an increasing proportion of PVD-related LLA procedures will prompt the health professionals to develop strategies for LLA prevention.

Effectivity of National Health Insurance on Maternal Health in Developing Countries: A Systematic Review

2020 ◽  
Author(s):  
Eva Nur Octavia ◽  
◽  
Pandu Riono ◽  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Developing Countries ◽  
Health Insurance ◽  
Maternal Health ◽  
National Health Insurance ◽  
National Health ◽  
Population Studies

Department of Biostatistics and Population Studies, Faculty of Public Health, Universitas Indonesia

How Single-payer Stacks Up: Evaluating Different Models of Universal Health Coverage on Cost, Access, and Quality

2018 ◽  
Vol 48 (3) ◽  
pp. 568-585 ◽  
Author(s):  
Ashley Fox ◽  
Roland Poirier
Keyword(s):  
United States ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Universal Coverage ◽  
The United States ◽  
Health Coverage ◽  
Single Payer ◽  
Access And Quality ◽  
Universal Health

Described as “universal prepayment,” the national health insurance (or single-payer) model of universal health coverage is increasingly promoted by international actors as a means of raising revenue for health care and improving social risk protection in low- and middle-income countries. Likewise, in the United States, the recent failed efforts to repeal and replace the Affordable Care Act have renewed debate about where to go next with health reform and arguably opened the door for a single-payer, Medicare-for-All plan, an alternative once considered politically infeasible. Policy debates about single-payer or national health insurance in the United States and abroad have relied heavily on Canada’s system as an ideal-typical single-payer system but have not systematically examined health system performance indicators across different universal coverage models. Using available cross-national data, we categorize countries with universal coverage into those best exemplifying national health insurance (single-payer), national health service, and social health insurance models and compare them to the United States in terms of cost, access, and quality. Through this comparison, we find that many critiques of single-payer are based on misconceptions or are factually incorrect, but also that single-payer is not the only option for achieving universal coverage in the United States and internationally.

Why Some Countries Have National Health Insurance, others Have National Health Services, and the United States Has Neither

1989 ◽  
Vol 19 (3) ◽  
pp. 383-404 ◽  
Author(s):  
Vicente Navarro
Keyword(s):  
United States ◽  
Health Insurance ◽  
Health Services ◽  
National Health Insurance ◽  
National Health ◽  
Labor Movement ◽  
Health Sector ◽  
Developed Countries ◽  
The United States ◽  
Social Force

This article presents a discussion of why some capitalist developed countries have national health insurance schemes, others have national health services, and the United States has neither. The first section provides a critical analysis of some of the major answers given to these questions by authors belonging to the schools of thought defined as “public choice,” “power group pluralism,” and “postindustrial convergence.” The second section puts forward an alternative explanation rooted in a historical analysis of the correlation of class forces in each country. The different forms of funding and organization of health services, structured according to the corporate model or to the liberal-welfare market capitalism model, have appeared historically in societies with different correlations of class forces. In all these societies the major social force behind the establishment of a national health program has been the labor movement (and its political instruments-the socialist parties) in its pursuit of the welfare state. In the final section the developments in the health sector after World War II are explained. It is postulated that the growth of public expenditures in the health sector and the growth of universalism and coverage of health benefits that have occurred during this period are related to the strength of the labor movement in these countries.

NATIONAL HEALTH INSURANCE: CAN WE LEARN FROM CANADA? Edited by Spyros Andreopoulos. New York, John Wiley & Sons, Inc., 1975, $10.95; 273 pp

PEDIATRICS ◽  
1976 ◽  
Vol 58 (5) ◽  
pp. 779-780
Author(s):  
George M. Wheatley
Keyword(s):  
United States ◽  
New York ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
The United States ◽  
Social Program ◽  
National Program ◽  
Distant Future

The assumption is widely prevalent that the United States will have in the not too distant future some form of national health insurance. The questions being debated now are what kind of national program and how it will be legislated. Now that we may be on the threshold of another multibillion dollar social program, it is prudent to examine carefully the successes and errors of other countries in order to guide our planners to wise decisions and to avoid costly mistakes.

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