Solving the Health Care Problem: How Other Nations Succeeded and Why the United States Has Not

Examines Australia and Canada to help explain why the United States provides less health care protection than other democratic nations.

The United States is the only industrialized democracy that allows its citizens to go entirely without health care for lack of funds or to be bankrupted by medical bills. Author Pamela Behan was confronted by the effects of this policy failure during her previous career as a nurse, and with Solving the Health Care Problem, she examines how it can be corrected. Behan explores American health care policy failure by looking at how two other, similar nations—Canada and Australia—managed to adopt health care protections, and compares their stories with events in the United States. Behan’s systematic comparison of all three nations shows that the factors responsible for these different results center on the responsiveness of each nation’s political institutions to its voters. In particular, Australia’s parliamentary system and labor party and Canada’s constitutional flexibility and national-provincial dynamics proved central to each nation’s adoption of national health insurance. In contrast, similar efforts in the United States became less frequent and less ambitious after they were repeatedly blocked without even coming to a vote. These dissimilarities reveal the institutional and class issues that must be addressed for the United States to successfully confront the health care problem.

“This is an interesting, well-written, and thoughtful account of health care policy and American exceptionalism from a comparative perspective. Behan brings together a wealth of information to make a valuable contribution to the social policy/political sociology literature.” — Gregg M. Olsen, author of The Politics of the Welfare State: Canada, Sweden, and the United States