I actually had a portion on the history of health reform in Canada in the original draft of my article. Here it is:
None can doubt Massachusetts and California's roles in reinvigorating the debate over national health care. So a second consideration comes into play: Even if state-based plans are unlikely to work in the long-term, they'll serve to accelerate the transition to a national care system. That, after all, is what happened in Canada. The first universal plan came out of the Saskatchewan province, then the area's representatives to Parliament became dedicated advocates of the model, and they forced it into the national debate. A likelier analogue in this country would be that one of the governors who passes a universal plan runs for president partially on a platform of expanding the model.
That has its dangers too, though. Mitt Romney, for instance, is running for president. And while his desperation to shore up his conservative bona fides has kept him pretty quiet about the plan, if he made it to the general election, observers expect that it would become central to his national appeal. The problem is it's not clear that scaling a state plan up is a wise solution. “What states find attractive because they have to work around all these barriers may not be what the feds should find attractive, because they don't have to face those same barriers,” says [Jacob] Hacker. “So Massachusetts is a pretty elegant reform idea in part because it won't run afoul of [the Employee Retirement Income Security Act] and in part because it won't require much new money. But it looks pretty bad on other dimensions, like what's the coverage that you're getting and what's the guarantee that it'll reach the uninsured.” To construct a national plan that builds in the peculiar limitations of the states while eschewing the unique powers of the federal government would be disastrously bad policy.
That said, one of my main points in the article is that the primary utility of these plans is in providing momentum for the issue on the national level. But you couldn't simple repeat the Canadian formula: What American states can do is very different from what Canadian provinces were capable of pulling off. And what a state could do to regulate the medical industry and fund health care in 1946 are rather different than what one can do in 2007. I assume I don't have to explain why in super great detail. All that said, I do like Sirota's admission that the way he researches this stuff is to "[s]pend 5 minutes on Wikipedia."
At least he's honest.
