Solving the Health Care Problem: How Other Nations Succeeded and Why the United States Has Not

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SUNY Press, Jun 1, 2007 - Health & Fitness - 171 pages
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The United States is the only industrialized democracy that allows its citizens to go entirely without health care for lack of funds or to be bankrupted by medical bills. Author Pamela Behan was confronted by the effects of this policy failure during her previous career as a nurse, and with Solving the Health Care Problem, she examines how it can be corrected. Behan explores American health care policy failure by looking at how two other, similar nations—Canada and Australia—managed to adopt health care protections, and compares their stories with events in the United States. Behan’s systematic comparison of all three nations shows that the factors responsible for these different results center on the responsiveness of each nation’s political institutions to its voters. In particular, Australia’s parliamentary system and labor party and Canada’s constitutional flexibility and national-provincial dynamics proved central to each nation’s adoption of national health insurance. In contrast, similar efforts in the United States became less frequent and less ambitious after they were repeatedly blocked without even coming to a vote. These dissimilarities reveal the institutional and class issues that must be addressed for the United States to successfully confront the health care problem.
  

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Contents

WHAT CAN THE APPROACH TELL US?
1
CANADA
5
Canadian Health Care Reform Initiatives
16
Theoretical Explanations and Canadian Health Policy
30
AUSTRALIA
33
Australian Health Care Reform Initiatives
38
Theoretical Explanations and Australian Health Policy
53
THE UNITED STATES
59
CONCLUSION
111
What the Systematic Study Adds
115
So What?
117
Limitations to the Study
119
Directions for Future Research
120
The Selection of Cases
123
A Typology of Health Policy Outcomes
126
The Choice of Causal Factors
132

Historical Influences and Legacies
60
Division Delay and Private Entrenchment
67
US Health Care Reform Initiative
72
Theoretical Explanations and US Health Policy
85
A SECOND SYSTEMATIC APPROACH
91
A Systematic Comparative Historical Method
97
The Qualitative Comparative Analysis
99
Results
107
The Final Sixteen Factors and Constants
137
A Short Introduction to Qualitative Comparative Analysis
138
Tables used in the Qualitative Comparative Analysis
141
NOTES
145
BIBLIOGRAPHY
149
INDEX
163
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About the author (2007)

Pamela Behan is Assistant Professor of Sociology at the University of Houston–Downtown.

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