Another factor of divergence of the Canadian and American health care systems is the party discipline. In Canada, party members are expected to vote along party lines, allowing the political party in power to control the House of Commons. In the U.S., while many issues are voted along party lines, party discipline is “not a functional requirement,” making it harder for the ruling political party to exert full control over decisions made in Congress. Maioni argues, that the force of party discipline was a major factor in establishing universal medical coverage in Canada. Once Prime Minister Lester Pearson supported nationwide health coverage in the mid-'60s, the bill was sure to pass, as cabinet ministers were expected to vote along the party
