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Home Policy Articles: Health Care: Privatization


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Bad Medicine: Trade Treaties, Privatization and Health Care Reform in Canada popular

Jim Grieshaber-Otto and Scott Sinclair examine a central and recurring theme in Canada’s health care debate: whether private financing and for-profit delivery of health care should play a greater role. They contend that exploring Canada’s international trade-treaty obligations as well as the scope of exemptions for health care under those treaties, add a critical dimension to this important debate.

Health Care Reforms: Just How Far Can We Go? popular

Philippe H. Trudel, Bruce W. Johnston, and Michel Bédard explore what kinds of health care reforms can occur under existing laws. They also examine how much room the provinces have to manoeuvre under current federal legislation, namely, the Canada Health Act, as well as which laws reform-minded provincial governments could modify.

2028 or Bust: Ontario's Unsustainable Hospital Spending

This brief Fraser Alert argues that public spending in Ontario hospitals is on an unsustainable financial track.

A Return to Wage Discrimination: Pay Equity Losses Through the Privatization of Health Care

The BC government’s actions to facilitate health care privatization have reversed more than 30 years of pay equity gains for women in health support occupations. Marjorie Griffin Cohen and Marcy Cohen cite historical statistics, which show that from the 1960s to 2001, the pay equity gains won by women in hospital support work were remarkable, but fair.

Beyond Romanow: Why $3.5 Billion is Not Enough

In this Canadian Centre for Policy Alternatives publication Armine Yalnizyan argues that the $3.5 billion in health care spending proposed by the Romanow Report does not constitute sufficient funding to implement the Report’s recommendations. While Yalnizyan notes the Romanow recommendations are critical first steps to securing public health care, she maintains that the level of funding proposed will leave many pressing health care needs unanswered. According to Yalnizyan, Canadian health care is in such dire need of increased funding that $3.5 billion will simply be absorbed into the system, leaving no room for substantive policy change. She contends that if funding is not increased to levels beyond the Romanow recommendations, the result will be the ‘passive-aggressive privatization’ of Canadian health care.

California Dreaming: The Fantasy of a Canadian-Style Health Insurance Monopoly in the United States

The stated purpose of Brett Skinner and Mark Rovere’s article is to “warn Americans about the dangerous ideas contained in the Universal Health Insurance bill.”

Can we Afford to Sustain Medicare? A Strong Role for Federal Government

This report, prepared for the Canadian Federation of Nurses Unions (CFNU), is intended to be a message from Canadian nurses to all provincial premiers. According to the CFNU, Canada has entered a new era of possibility for public health care: a new federal Parliament; new provincial leaders; a new health accord in the making; and, an unparalleled consensus that change must happen immediately.

Can We Finally Move Forward to Improve Health Care?

In this brief report, Kouri recommends ways to realize this vision for health care in the Province. She argues that residents of Saskatchewan must continue demanding high quality services; she also recommends a reorganization of primary care, and an increased emphasis on community-based care.

Every Number Tells a Story: A Review of Public and Private Health Expenditures and Revenues in Canada, 1980-2000

This article by Glenn Brimacombe analyzes public versus private health care spending in Canada from 1980 to 2000. In this regard, the author finds there has been no drastic move towards increased private spending, even though the author does note some increases. Brimacombe underscores that there are important differences within the health care field, with sectors functioning in fundamentally different manners from one another (physicians versus other professionals, for example). Accordingly, Brimacombe argues that Canada must bring together these sectors in a more “financially seamless structure” prior to embarking on health care reform. Finally, the author considers the particulars of Canada’s situation vis-à-vis other international cases (such as Australia).

Expenditure on Medical Care in Canada: Looking at the Numbers

Brian Ferguson’s paper Expenditure on Medical Care in Canada: Looking at the Numbers, argues the only option to afford the level of health services Canadians have become accustomed to is to allow greater private spending. Ferguson asserts the way Canadians pay for health care has changed. In the past, governments had “the luxury” of running deficits and Medicare was financed based on borrowing. Today, however, Ferguson points out health care must be paid out of current revenues. These higher costs leave governments with the option of raising taxes, reducing services, or turning to private funds.

Funding Hosptial Infrastructure: Why P3s Don't Work, and What Will

This report examines the consequences of adopting a “public-private partnership,” more commonly known as a P3 model, for the delivery of health care infrastructure and services.

Getting Better Health Care: Lessons from (and for) Canada

This paper attempts to examine the nature of Canada’s health care system to determine what lessons have been learned and assess forward movement in the debate over health care reform.

Health Care Restructuring in BC

Fuller, Fuller and Cohen argue the BC health care system has entered a period of profound upheaval. All around the province, changes are being made to the health care services offered and how they are delivered. The authors contend, however, that the changes implemented are not the right medicine for the BC health care system.

How Good is Canadian Health Care? 2004 Report: An International Comparison of Health Systems

This report compares Canada to other countries that also have universal access to health care through publicly funded health care systems.

Ill-Health Canada: Putting Food and Drug Company Profits Ahead of Safety

This book is available only for purchase from the Canadian Centre for Policy Alternatives (CCPA). Michael McBane argues that Canada’s political and industry elites have made their choice: corporate profits are to trump the protection of citizens’ health. He cites evidence indicating that the federal health and safety regulatory agencies have been captured by the industry, and that these agencies are now rigged to deceive the public.

Improving Canadian Health Care: Better Ways to Finance Medicare

In Improving Canadian Health Care: Better Ways to Finance Medicare, Brett Skinner, of the Atlantic Institute for Market Studies, proposes two models for reforming Canada’s health care system. Skinner argues Canada’s current approach to health care – and the ensuing wait times, tax increases, and service reductions – are not sustainable. He believes reform is necessary, but first, he claims, government must understand how health insurance and the medical market work, reform advocates must move away from strict ideological requirements for reform, and policymakers must explore how health care is utilized to predict the economic effects of reform.

Interactions: Trade Policy and Healthcare Reform After Chaoulli v. Quebec

Is it time for Canada to acknowledge the fragile boundary between health and trade policies and strengthen the separation between private-and public-health insurance? The author argues that the Chaoulli decision of June 09, 2005, necessitates a review of the interface between trade agreements such as NAFTA and the GATS and medicare .

Making Health Spending Work

This article by Fred McMahon and Martin Zelder attempts to incorporate Medical Savings Accounts (MSAs) into the current health care system so that “a publicly funded system that incorporates market dynamics” can be designed. In McMahon and Zelder’s plan, Medical Savings Accounts would be attributed to each Canadian citizen, who would then have the option of choosing between private and public providers of health care. The authors believe this option makes most sense considering that Canada ranks near the top of OECD (Organization for Economic Co-operation and Development) member countries with respect to health spending, but places near the bottom in most categories pertaining to the quality of health care service delivery.

Medically Uninsured Americans: Evidence on Magnitude and Implications

This article by Cal Irvine and Martin Zelder examines the nature and number of medically uninsured Americans. The authors contend that the existence of this group forms the primary argument for those in Canada who defend the status quo in Canadian health care, offering proof of the public health care system's "superiority" over the "private" health care of the United States. The authors further argue that the true number of uninsured Americans is significantly lower than the 43 million estimated by the 1997 Current Population Survey (CPS), placing the number closer to 38 million. Irvine and Zelder suggest that an important number of these, some 12 to 15 million, choose, for their own reasons, to remain uninsured.

Medicare as a Moral Enterprise: The Romanow and Kirby Perspectives

In this paper Thomas Courchene compares and contrasts the values (or operating principles) that underpin the Romanow and Kirby health care reports. He first identifies these values in each report, and then analyzes how they are similar, how they differ, and which report ultimately offers the best solution to building a sustainable health care system for Canada.

Medicare, the Medical Brain Drain and Human Resource Shortages in Health Care

Brett Skinner’s report Medicare, the Medical Brain Drain and Human Resource Shortages in Health Care, published by the Atlantic Institute for Market Studies, argues that Medicare reform is necessary for Canada to retain its health care professionals. Due to the limitations of public spending, Skinner asserts, Medicare as government monopoly suppresses medical professionals’ wages, keeping them below what doctors and nurses could earn in the free market. This continuing wage suppression is an incentive for professionals to move to the US, creating, Skinner claims, a labour shortage in Canadian health care.

Miracle Cure: How to Solve America's Health Care Crisis and Why Canada Isn't the Answer

This is a book-length report written by Dr. Sally C. Pipes, President and CEO of the Pacific Research Institute.

Paying for Keeps: Securing the Future of Public Health Care - Health Care Talks: The constitutional debate revisited

Paying for Keeps is a series by Armine Yalnizyan examining the future of public health care in Canada. In this issue, Yalnizyan looks specifically at the February 2003 First Ministers’ Meeting, which she argues will profoundly shape the future of public health care.

Paying More, Getting Less: Ontario's Health Premium and Sustainable Health Care

In this report, Brett Skinner looks at the Ontario Health Premium, introduced in the 2004 Ontario budget.

Profits and the Hospital Sector: What does the Literature Really Say?

In Profits and the Hospital Sector: What does the Literature Really Say?, Brian Ferguson, of the Atlantic Institute for Market Studies, argues economics literature is often misused in discussions of for-profit health care reform. According to Ferguson, resolving the question of the potential role of for-profit health facilities is difficult due to the complexity of hospital care (both from a patient and a business perspective). Despite these difficulties, Ferguson asserts that policymakers need to have some sort of idea as to how different factors affect costs in order to make decisions on for-profit care. He believes that a thorough evaluation of the literature on for-profit health care reform will provide this idea.

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