Interest groups, public opinion, and path dependence: how Canada and the U.S diverged on healthcare policy
Bibliographic record
Abstract
Despite being comparatively similar countries, the United States and Canada have taken very different historical tracks to developing their respective health care systems. While Canada incrementally developed a system of universal coverage through national public insurance, the United States repeatedly failed to achieve universal healthcare reform and infamously maintains its hybrid public-private system to this day. Scholars of comparative politics have produced numerous competing accounts of the conditions under which health care policy change occurs and explanations for the major factors that shaped policy divergence. However, there are few studies dedicated to explaining mechanisms for continued policy divergence and its impacts on public opinion. In this thesis, I comparatively examine the passage of Medicare in the United States in 1965 with the Canadian Medical Care Act of 1966 and present the results of a nationally representative U.S. public opinion survey. I find that a mechanism of path dependence, whereby interest groups and constituencies that participate in policy battles are strengthened or curtailed by their outcomes, weighed disproportionately on the power of the former in the United States. In Canada, path dependence created a stalemate in which early forms of policy entrepreneurship made healthcare expansion and reduction equally difficult to achieve. The contemporary survey reveals that U.S. public opinion largely favors healthcare reform on matters of principle rather than policy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.004 | 0.007 |
| Science and technology studies | 0.018 | 0.016 |
| Scholarly communication | 0.009 | 0.004 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".