National health insurance: Some lessons from the Canadian experience

In the current American debate over national health insurance an examination of the Canadian governmental experience is very instructive. Canada is enough like the United States to make the effects of Canadian health insurance policies rather like a large natural experiment. The Canadian experience—universal government health insurance administered by the ten provinces with some fiscal and policy variations—can be used to predict the impact in the United States of proposed national health insurance plans on the medical care system, and the reaction of mass publics and national policymakers to these effects.The central purpose of the Canadian national health insurance was to reduce and hopefully eliminate financial barriers to medical care. In this it succeeded. But it also produced results which Canadian policymakers never anticipated: essentially unexpected side-effects on cost, quality, organization, and manpower distribution of the particular national health insurance program adopted. It should be cause for concern, the article concludes, that most of the prominent American national health insurance proposals resemble the Canadian program in failing to provide a single level of government with both the means and incentives to curb the inflationary effects of national health insurance. The lesson from Canada is that unless the system has very strong anti-inflationary mechanisms and incentives built into it, national health insurance will feed the fires of medical inflation despite great formal governmental authority to control it.     

THE DETERMINATION OF ANTITRUST LIABILITY IN UNITED STATES v. MICROSOFT: THE EMPIRICAL EVIDENCE THE DEPARTMENT OF JUSTICE USED TO PROVE ITS CASE

This paper considers the empirical evidence used by the Departmentof Justice in the U.S. v. Microsoft antitrust case to provethat Microsoft engaged in exclusionary (and anticompetitive)actions in the browser market as part of its efforts to maintainits dominance of the personal computer operating system market.This evidence deserves special consideration because the DistrictCourt made the unusual decision to rely on the empirical evidencepresented by the Department of Justice rather than the empiricalevidence presented by Microsoft. This decision was unusual becauseMicrosoft's evidence had a strong presumption of validity asit was based on data that Microsoft collected and used in theordinary course of its business. Furthermore, no market participantsused the Department of Justice-sponsored data in any meaningfulway. Although it is impossible to determine with any certaintywhy the District Court ruled the way it did, I conclude thatthere were two driving forces in the court's decision. The Departmentof Justice identified serious flaws in Microsoft's data, makingit unreliable for the purposes for which Microsoft was usingit in the trial. The Department of Justice was also able toshow that no such flaws affected the data it sponsored and indeed,on many points, that data was more consistent with the testimonyof Microsoft executives than the data sponsored by Microsoft.     

Settling Like a State: Acehnese Refugees in Vancouver

In Canada, the phenomenon of urban refugees is largely an expressionof state-managed practices, not spontaneous migration and settlement.This study focuses on the distinctly North American, and specificallyCanadian, experiences of pre-meditated, state-planned, government-managedmigration and settlement for urban refugees from the Aceh regionof Indonesia to Vancouver, British Columbia in 2004. It exploreswhy and how these refugees came to Vancouver; the state policydecision that located all of them in one city; and how theyhave fared in acquiring official language proficiency and employment.Whereas many refugees move to urban centres to enhance educationaland employment opportunities, this study illustrates the obstaclesto accessing both in Vancouver. Despite full legal status andaccess to employment sanctioned by the host state, there isno guarantee that refugees will have an easier time creatinglivelihoods under dramatically new conditions. The analysisis based on research conducted between January and August 2005during which a survey of housing, employment, and income issueswas conducted with 70 of the 104 Acehnese refugees who had relocatedto Vancouver since February 2004. In addition, a one-day, three-partseries of focus groups was held during which 47 members of theAcehnese community took part. Discussions centred on three keymoments during their migration: (1) while in Malaysian detentioncamps; (2) upon arrival in Vancouver, British Columbia; and(3) during the first year of settlement in the city, to ascertaincommon settlement experiences, policy implications, and theshort-term ‘success’ of the resettlement.     

Coercion,Information, and the Success of Sanction Threats

This article explores when and why sanction threats succeed in extracting concessions from the targeted country. We focus on two different, albeit not mutually exclusive, mechanisms that can explain the success of sanction threats. The first mechanism relates to incomplete information regarding the sanctioner's determination to impose sanctions and suggests that threats help to extract concessions by revealing the sanctioner's resolve. The second mechanism underscores the direct impact of common interest between the two countries and explains the success of sanction threats by the targeted country's greater dependence on this link between the two countries and the sanctioner's ability to exploit this dependence. We test the hypotheses using a new strategic structural estimator. Our results provide no evidence in favor of the informational hypothesis, while lending robust support for the coercive hypothesis.