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Home Policy Articles: Health Care: Insurance

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California Dreaming: The Fantasy of a Canadian-Style Health Insurance Monopoly in the United States

The stated purpose of Brett Skinner and Mark Rovere’s article is to “warn Americans about the dangerous ideas contained in the Universal Health Insurance bill.”
http://www.fraserinstitute.ca/admin/books/files/CaliforniaDr...

Canadian Health Insurance: An Unregulated Monopoly

In Canadian Health Insurance: An Unregulated Monopoly David Zitner, of the Atlantic Institute for Market Studies, calls for a strengthening of government’s role as health care regulator with a corresponding reduction in influence on service delivery and evaluation. Zitner argues Canadian health care is an unregulated monopoly. Provinces set prices for delivery while at the same time influencing the supply of health care through funding levels. This, Zitner stresses, is a conflict of interest that makes it impossible for government to fulfill its role as regulator of the system. Moreover, the conflict between government roles of insurer and regulator leads, Zitner asserts, to practices that would be deemed unacceptable in a private insurance market.
http://www.aims.ca/library/monopoly.pdf

Canadian Pharmacare: Performance, Incentives, and Insurance

In this paper, Graham and Tabler examine provincial drug policy. They argue that since the 1970s, provincial governments have taken away the freedom of Canadians to choose the prescription drugs they use. The result has been that provincial drug-benefit plans account for almost one-half of Canada’s prescription drug spending, placing an undue burden on taxpayers. At the same time, they argue is has been difficult to see the benefit to patients who require the drugs.
http://www.fraserinstitute.ca/shared/readmore.asp?sNav=pb&id...

Choosing a regulatory framework for private health insurance

In this economic note Norma Kozhaya discusses how to set up private health insurance and regulatory pitfalls to avoid.
http://www.iedm.org/uploaded/pdf/mars06_en.pdf

Hamstrung and Hogtied: Cascading Constraints on Citizen Governors

In this paper Colleen Flood and Tom Archibald look at what type of role citizen governors may be able to play in improving accountability within the Medicare system. Flood and Archibald systematically examine five levels of decision-makers within Medicare and their roles, then question whether or not citizen governors, or another form of citizen engagement would improve accountability within the system. The authors explain that although there had been an increase in citizen participation it's positive effects were tempered by the move away from citizen governance and towards arm's length community councils. Ultimately more meaningful citizen participation is encouraged.
http://www.cprn.ca/documents/37473_en.pdf

Hamstrung and Hogtied: Cascading Constraints on Citizen Governors

In this paper Colleen Flood and Tom Archibald look at what type of role citizen governors may be able to play in improving accountability within the Medicare system. Flood and Archibald systematically examine five levels of decision-makers within Medicare and their roles, then question whether or not citizen governors, or another form of citizen engagement would improve accountability within the system.
http://www.cprn.com/documents/37473_en.pdf

Making Health Spending Work

This article by Fred McMahon and Martin Zelder attempts to incorporate Medical Savings Accounts (MSAs) into the current health care system so that “a publicly funded system that incorporates market dynamics” can be designed. In McMahon and Zelder’s plan, Medical Savings Accounts would be attributed to each Canadian citizen, who would then have the option of choosing between private and public providers of health care. The authors believe this option makes most sense considering that Canada ranks near the top of OECD (Organization for Economic Co-operation and Development) member countries with respect to health spending, but places near the bottom in most categories pertaining to the quality of health care service delivery.
http://www.fraserinstitute.ca/admin/books/files/MakingHealth...

Medically Uninsured Americans: Evidence on Magnitude and Implications

This article by Cal Irvine and Martin Zelder examines the nature and number of medically uninsured Americans. The authors contend that the existence of this group forms the primary argument for those in Canada who defend the status quo in Canadian health care, offering proof of the public health care system's "superiority" over the "private" health care of the United States. The authors further argue that the true number of uninsured Americans is significantly lower than the 43 million estimated by the 1997 Current Population Survey (CPS), placing the number closer to 38 million. Irvine and Zelder suggest that an important number of these, some 12 to 15 million, choose, for their own reasons, to remain uninsured.
http://www.fraserinstitute.ca/admin/books/files/US-uninsured...

Paying More, Getting Less: Ontario's Health Premium and Sustainable Health Care

In this report, Brett Skinner looks at the Ontario Health Premium, introduced in the 2004 Ontario budget.
http://www.fraserinstitute.ca/admin/books/files/PayingMoreGe...

The Alberta Health Care Advantage: An Accessible, High Quality, and Sustainable System

In this paper, Esmail and Ramsay address the subject of health care reform in Alberta. They examine the Mazankowski Report, the product of a study conducted by the Premier’s Advisory Council on Health for Alberta; the Report delivered a radical set of ideas to raise health care revenues and temper demand for health services, in order to make Alberta’s health care system more sustainable.
http://www.fraserinstitute.ca/admin/books/files/ABHealth.pdf...

The Boundaries of Medicare: The Role of Ontario's Physician Services Review Committee

Flood and Erdman’s paper is part of the working paper series entitled Defining the Medicare Basket: Health Care Decision Making in Canada. This series was undertaken to examine how decisions are made about what is covered by publicly funded health care, and if decisions about what is covered should be revisited.
http://www.irpp.org/miscpubs/archive/medicare_basket/wp2004-...

The Misguided War Against Medicines: Are Drug Expenditures Making Public Health Insurance Financially Unsustainable?

Brett Skinner and Mark Rovere analyze the costs associated with drug expenditures and the overall sustainability of Canada’s health care system.
http://www.fraserinstitute.ca/admin/books/files/MisguidedWar...

Two myths about the U.S. health care system

Common criticisms of the US health care system are the lack of universality and the high percentage of those without coverage. Norma Kozhaya deconstructs these myths.
http://www.iedm.org/uploaded/pdf/juin05_en.pdf