Abstract

National responses to COVID-19 depend in part on national health care financing arrangements. Yet the pandemic itself has not only strained system capacity, it has – through subsequent economic shocks – strained revenue sources that prop up these arrangements. In federal countries, fiscal pressures are particularly pronounced. As this paper argues, however, federal health financing regimes differ in ways that are shaping the agenda for post-pandemic reforms. The analysis, which focuses on health care financing in three federal countries (Canada, the United States, and Mexico), explores the current and potential future impact of COVID-19 on existing policy legacies.

摘要

国家对COVID-19的反应部分取决于国家卫生保健筹资安排。然而，大流行本身不仅使系统容量紧张，而且在随后的经济冲击中，它使支持这些安排的收入来源也紧张。在联邦国家，财政压力尤为明显。然而，正如本文所论证的那样，联邦卫生筹资机制在决定大流行后改革议程的方式上有所不同。该分析着重于三个联邦国家（加拿大，美国和墨西哥）的卫生保健筹资，探讨了COVID-19对现有政策遗产的当前和潜在的未来影响。