Dalhousie Law Journal


health care, policy, Canada, United States, Canada Health Act, Clinton Health Security Act, Nova Scotia, Illinois, reform


This article focuses on current health policy changes in Canada and the United States at the federal and regionallevels. The Canadian discussion centres on the integrity of the Canada Health Act in the era of the Canada Health and Social Transfer, and the strategies that provincial governments have pursued to cope with persistent funding constraints. On the American side, the article examines the role of private sector managed care plans in filling a health policy void resulting from the demise of the Clinton Health Security Act. Two specific regional government health reform initiatives in Nova Scotia and Illinois are discussed as case studies of health care devolution on both sides of the border. The article concludes with a comparative discussion of the two regional reform programs and articulates lessons for health care policy in Canada and the United States from the Nova Scotia and Illinois experiences.