A View from a Friend and Neighbor: A Canadian Perspective on U.S. Healthcare and the Affordable Care Act
Colleen Flood and Bryan Thomas
This chapter examines healthcare reform in the United States under the Patient Protection and Affordable Care Act (ACA) from a Canadian perspective. It looks at healthcare reform in Canada and the United States in the latter half of the twentieth century and how the former made the transition to universal healthcare whereas the latter took a different path with the passage of Medicare and Medicaid. It then considers the two systems in an international context with regard to cost, access, depth of coverage, and healthcare outcomes. It highlights common perceptions about the U.S. system’s level of performance and the challenges faced by Canada in terms of access, quality, and expenditure. It also discusses the legal and regulatory framework governing health systems in both countries, with particular emphasis on the Canada Health Act and the ACA. The chapter concludes by outlining some common ideological and administrative challenges facing the two countries.