一全民覆盖的医疗保险制度实行市场经济的发达国家,从19世纪末期到20世纪中期,陆续形成了范围和程度不同的社会公共医疗保障制度。这其中的原因主要是市场机制在医疗业领域存在的局限性和经济、社会发展的客观要求。美国和加拿大在20世纪70年代前的医疗业制度的发展很相似。1971年,两国的医疗业支出都占GDP的7.5%左右。但1971年以后,两国的医 A universal coverage of the medical insurance system In the developed countries that have practiced a market economy, social public health insurance systems of different scopes and degrees have been formed successively from the late 19th century to the mid-20th century. The reason for this is mainly the limitations of the market mechanism in the medical field and the objective requirements of economic and social development. The development of the medical system in the United States and Canada by the 1970s was very similar. In 1971, medical spending in both countries accounted for about 7.5% of GDP. However, after 1971, medical treatment between the two countries