The Fate of National Health Insurance in Canada and the United States: A Multiple Streams Explanation

This article uses the multiple streams lens to describe why Canada eventually adopted national health insurance in the 1960s, compared with the most recent attempt at adopting national health insurance in the United States. The analysis strengthens the lens by paying close attention to the impact of differing institutional frameworks on the streams. It is found that the lens provides a useful description of the complexity of policymaking, pointing out critical elements in the process that are often overlooked.