ABSTRACT
In the realm of health care for the elderly, those institutions are dominated by the federal government's Medicare program. Global budgeting in health care can be defined as an institutional arrangement that has a single payer, comprehensive in both demographic scope and medical care coverage. United States pluralism is also strong within both the private and public sectors, further inhibiting any potential cooperative efforts to achieve something close to all-payer budgets on a national basis, as a close substitute for full global budgeting. The Oregon global budget might at least ensure cost-effectiveness among all of the poor. In Canada, all patients are eligible for care, and all bills are paid by the province Individual physicians may opt out of the system entirely, but few do because those who do may not provide services offered by the public system. In Canada, 90 percent flows through government budgets.
