Association for Public Policy Analysis & Management

Roundtable: Enhancing Coverage and Quality: Recent Health Policy Reforms and What Lies Ahead in Canada, Mexico, and the United States

(Global Health Policy)

This roundtable will draw on three new books on health systems in Canada, US and Mexico, published jointly by the World Health Organization and the University of Toronto Press, to explore the potential for sharing ideas about what does and doesn’t work across North American health systems. Canada has received worldwide attention for its “single-payer” health care system, which provides universal hospital and physician care free of patient cost sharing. Nevertheless, it faces several challenges, such as with financial access to prescription drugs and dental care, with waiting for specialist and surgical services, and slow adoption of changes in medicine and service delivery.  Mexico’s system is dominated by corporatist, national social insurance organizations governed by employer and employee trade unions in close relationship to the federal government, supplemented with government services for the uninsured, and a thriving private sector. Since 2004 Seguro Popular had made progress toward universal health coverage; however, President Lopez Obrador’s administration canceled Seguro Popular from 2020 and re-centralized health authority by establishing the federal government as sole funder and provider of coverage for the uninsured.  The U.S. has gone in a different direction, relying on managed competition. There is potential for policy learning across all three countries, from the innovative delivery and funding models in the U.S., the efforts to strengthen government negotiating power in Canada, to the successes in inter-sectoral policy action to address major health risks in Mexico. This roundtable will be of interest to policy scholars and researchers across North America and beyond.