Single-Payer Reform and Rural Health in the United States: Lessons from Our Northern Neighbor
Abstract
Single-payer health reform has secured its place in the mainstream American health policy debate, yet its implications for particular subpopulations or sectors of care remain understudied. Amidst many unanswered questions from policymakers and political pundits, rural health has emerged as one such area. This article explores rural Canada’s five-decade-long experience with a national publicly funded health insurance program as a valuable opportunity for cross-national learning. During March 2020, I conducted 13 semi-structured, elite stakeholder interviews with government officials, academic researchers, rural hospital executives, public health association leaders, rural health administrators, and representatives from provincial medical, hospital, and physician associations in Ontario. I found that a single-payer model confers notable advantages over a market-based model, includ
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[co-author: Rebecca Onie, and Rocco Perla]
Editor’s Note: In a new issue brief supported by the Blue Shield of California Foundation and the Commonwealth Fund, Manatt Health in partnership with The Health Initiative presents strategies for how states can buy health, not just health care. The issue brief presents seven strategies for addressing drivers of health (DOH), defined as socioeconomic, environmental and behavioral factors (e.g., homelessness, food insecurity, exposure to intimate partner violence (IPV), adverse childhood experiences (ACEs), racism and discrimination) that impact health. Click here to download a free copy of the full issue brief. To download a free copy of our recently published
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South Floridaâs Black communities are trapped in a vicious cycle of inequality. Access to adequate food and health sources to sustain impoverished neighborhoods is close to nonexistent.
For decades, Black people have been diagnosed with chronic illnesses such as heart disease, diabetes, cancer, obesity and hypertension at a much higher rate than any other group. Though genetic predispositions do play a role in these diagnoses, it all boils down to two things â diet and lifestyle choices.
At a time where preexisting conditions provide a deadly bullâs-eye for the coronavirus, food and pharmacy deserts have played a major role in the mortality rate among Black populations since the start of the pandemic. Both also contribute to the low vaccination rate in those same communities. The limited availability of supermarkets and pharmacies has proven to be critical to the well-being of Black communities â historically and now â as the pandemic rages on and pharmacie