The problems of America's health care system can best be addressedthrough market-based solutions. The evidence indicates that undernational health insurance, the promise of coverage becomes healthrationing, access to universal coverage means delays in access tocare, official fairness yields to favoritism by officials, freedomof choice becomes coerced conformity, and democratic deliberationis replaced by bureaucratic decision-making.
Single-Payer Reform and Rural Health in the United States: Lessons from Our Northern Neighbor
Abstract
Single-payer health reform has secured its place in the mainstream American health policy debate, yet its implications for particular subpopulations or sectors of care remain understudied. Amidst many unanswered questions from policymakers and political pundits, rural health has emerged as one such area. This article explores rural Canada’s five-decade-long experience with a national publicly funded health insurance program as a valuable opportunity for cross-national learning. During March 2020, I conducted 13 semi-structured, elite stakeholder interviews with government officials, academic researchers, rural hospital executives, public health association leaders, rural health administrators, and representatives from provincial medical, hospital, and physician associations in Ontario. I found that a single-payer model confers notable advantages over a market-based model, includ