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Yes, that’s a great point, but it’s important to understand how the status quo system came about. There’s a path dependency. It didn’t start as a top-down syste
by bhupy 6y ago
Yes, that’s a great point, but it’s important to understand how the status quo system came about. There’s a path dependency. It didn’t start as a top-down system, it happened from the bottom-up, and the Federal government only supplemented funds once the political will for the healthcare system was broad enough that literally every province was bought into it.
None of that is the case in the US yet. There have been attempts (by the Rs) to provide block grants to States which have received pushback by the Ds.
Also even today, the Canadian Federal government does not supply the majority of the funds for each Province’s insurance system, it’s still a minority relative to the Provinces. It’s an extraordinarily stable system because the power over whether the system continues to function is largely decentralized.
- refurb 6y agoThe federal transfer payments for healthcare are significant. I cant find exact numbers (no doubt they are out there), but I vaguely recall hearing it’s close to 50%. But yes, each province developed their own program and the federal government agreed to throw in funds as long as certain requirements were met. Not that different from federal highways funds in the US actually. That’s how the federal government maintains minimums for drinking age, DUIs, speed limits, etc.
- bhupy 6y agoAs of 2020, Federal transfer payments for healthcare amount to 22%: https://www.cmaj.ca/content/192/45/E1408 https://www.cmaj.ca/content/192/45/E1408 That shouldn't come as a surprise considering that just under 80% of all government spending in Canada is driven by the Provinces, and healthcare spending is the single biggest line item for most countries: https://www.oecd-ilibrary.org/docserver/reg_glance-2016-en.pdf?expires=1617284204&id=id&accname=guest&checksum=54F1928944827C265ADC8F904BB6DA90 https://www.oecd-ilibrary.org/docserver/reg_glance-2016-en.p... (Table 3.1: https://i.imgur.com/GDtBaVT.png https://i.imgur.com/GDtBaVT.png)
- refurb 6y agoThere you go. Didn’t know the share had dropped so much!