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Parting at the Crossroads: The Development of Health Insurance in Canada and the United States, 1940-1965 Author(s): Antonia Maioni Source: Comparative Politics, Vol. 29, No. 4 (Jul., 1997), pp. 411-431 Published by: Ph.D. Program in Political Science of the City University of New York Stable URL: http://www.jstor.org/stable/422012 . Accessed: 12/10/2013 14:05 Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at . http://www.jstor.org/page/info/about/policies/terms.jsp . JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to …show more content…

I argue that the federal structureand parliamentary institutionsof the Canadianpolitical system encouragedthe formationof a social democraticthirdpartyand enhancedits efficacy in promotinghealthpolicy reform. The institutionalconstraintsof the Americanpolitical system, in contrast,impeded and the emergenceand consolidationof this type of policy "entrepreneur" forced the proponentsof health reformto restraintheir strategiesin orderto appeal to a wider coalition within the Democratic party.8The research methodology used in this article is based on comparativehistorical analysis, which involves examining the historical evidence for causal regularities and evaluating different explanatory factors that can account for divergent paths to social reform.9Here, I trace the postwar development of health reform in Canada and the United States, on concentrating the quarter centurybetween 1940 and 1965 when the two countries parted in their approachtoward health reform. The significant difference, as the historical evidence suggests, is the presence of a social democraticthird party in Canada able to influence the trajectory of health reform that resulted in the implementationof public, universalhealth insurance. Institutions, Parties, and Health Reform Institutional arrangementshave been identified as among the most important constraintsstill faced by health reformersin the United States. 'oStill, the linkages

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