Y. Dufresne, S. Jeram and A. Pelletier (2014), The True North Strong and Free Healthcare? Nationalism and Attitudes towards Private Healthcare Options in Canada, Canadian Journal of Political Science, 47(3): 569-595 (original) (raw)
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The political use of poll results about public support for a privatized healthcare system in Canada
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Objectives: Within the context of the political debate on privatization of healthcare funding in Canada, this paper examines the nature and the various role of polls. Methods: To reach this objective we rely on available commercial polls and statistical surveys and qualitatively analyse them to illustrate methodological and logical problems as well as to distinguish between what we call the 'informative' and the 'political' use of poll results. Results: We first draw a portrait of Quebecers' and Canadians' positions on the healthcare system and use this portrait to highlight a certain number of logical and methodological issues related to the political use of polls. Our analysis shows that public support for privatization of the healthcare system, as presented in the polls, is a construct whose logical underpinnings and methodological validity are extremely weak. Conclusions: We then discuss those results to argue that polls are not only used to represent the public's preferences but are also political tools used to shape those preferences.
Stakeholder Views on Privatization of the Quebec Health Care System
Canadian Public Policy, 2016
In 2005 the Supreme Court of Canada issued a landmark ruling in the debate on privatization of Quebec's health care system. The Quebec government subsequently made several decisions, such as lifting the ban on private insurance for some health services already offered in the public system. We interviewed 42 stakeholders who were involved in the decision process between 1999 and 2008 and analyzed their views. We identified three types of positions on privatization, based on two key factors raised in these encounters: (a) the ideological and political inertia of both civil society and the state and (b) the concerted action of stakeholders.
Journal of Health Politics Policy and Law, 1995
Health insurance was one of the most influential social reforms on the immediate postwar agenda in Canada and the United States. In both cases, proposals for national health insurance were not implemented. This article traces the evolution of these legislative proposals of the 1940s and shows how the events of this pivotal decade set the stage for future health reform in the two countries. The analysis focuses on how political institutions condition the role of state actors and the articulation of societal groups, and particularly on the crucial differences in party systems and the role of parties in shaping health reform in the two countries. In the United States, a divided Democratic party and the imperatives of political compromise made forging a consensus around health insurance more difficult. In Canada, meanwhile, the presence of a social-democratic third party led to a very different type of debate about health reform and opened the door for national health insurance.
Health Economics, Policy and Law, 2010
Choice is often touted as a means for change within health care systems. Yet ‘choice’, in this context, takes at least three distinct forms: choice between providers within a publicly funded health care system; choice between competing insurers within a universal plan; and, lastly, choice as between privately financed health care and universal public coverage. In Canada, it is this last form of choice that is under active debate; particularly in light of the Supreme Court of Canada’s decision in Chaoulli, which found a regulation banning private health insurance for medically necessary care was unconstitutional. The argument is frequently made that Canada is an outlier from other countries in having regulation that effectively precludes this kind of choice. This issue is likely to become of concern again in upcoming constitutional challenges where applicants are looking to overturn through judicial challenges Canada’s medicare system. This article tests that argument of whether Cana...
Canadian Federalism and the Canadian Health Care Program: A Comparison of Ontario and Quebec
International Journal of Health Services, 1987
The Quebec and Ontario health insurance and health service delivery systems, developed within the parameters of federal regulations and national financial subsidies, provide generally universal and comprehensive basic hospital and medical benefits and increasingly provide for the delivery of long-term care services. Within a framework of cooperative federalism, the health care systems of Ontario and Quebec have developed uniquely. In terms of vital statistics, the health of Ontario and Quebec residents generally is comparable. In viewing expenditures, Quebec has a more clearly articulated plan for providing accessible services to low-income persons and for integrating health and social services, although it has faced some difficulties in seeking to achieve the latter goal. Its plans for decentralized services are counterbalanced by a strong provincial role in health policy decision-making. Quebec's political culture also allows the province to play a stronger role in hospital pl...
Nations and Nationalism, 2006
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Canada : national-building in a federal welfare state
Http Edoc Vifapol De Opus Volltexte 2008 387 Pdf Ap_06_2004 Pdf, 2004
In Canada, three distinct models of federalism govern different social programmes: classical federalism, with programmes run exclusively by one level of government; shared costs federalism, with the federal government financially supporting provincial programmes; and joint-decision federalism, where formal approval by both levels of government is mandatory before any action can take place. Each of these models creates different decision rules, altering the mix of governments and ideologies at the bargaining table, redistributing power among those who have a seat at the table, and requiring different levels of consensus for action. The result has been three separate kinds of interactions between institutions and policy during the postwar era of welfare state expansion. As in the era of expansion, the new politics of social policy in the 'silver age' had to flow through the three distinctive institutional filters created by federal institutions, helping to explain the uneven impact of retrenchment in Canada. Exclusively federal programmes were unprotected by intergovernmental relations and fully exposed to shifts in national politics, with dramatic cuts especially in unemployment benefits. In contrast, joint-decision federalism helped protect contributory pensions from radical restructuring; while sharedcost federalism made it possible to preserve the basic model of the health care system, at least in respect of hospital, physician and diagnostic services, if not always in respect of the generosity of funding. Zusammenfassung Drei unterschiedliche Föderalismusmodelle charakterisieren Kanadas Sozialpolitik: Politikverflechtung, klassischer (dualer) Föderalismus und 'shared costs federalism'. Jedes dieser Modelle generiert unterschiedliche Entscheidungsregeln, Akteurs-und Machtkonstellationen sowie Konsensschwellen für politisches Handeln und hat folglich sowohl die Expansion des kanadischen Wohlfahrtsstaates als auch dessen Rückbau unterschiedlich beeinflusst. Während die Politikverflechtung auf dem Gebiet der beitragsfinanzierten Renten sowohl den Programmausbau als auch den-rückbau gebremst hat, wurden die ausschließlich vom Bund regulierten Programme sowohl in der Expansionsals auch in der Konsolidierungsphase maßgeblich von den politischen Kräfteverhältnissen auf der nationalen Ebene bestimmt. Der in der Gesundheitspolitik praktizierte shared costs federalism bot in der Expansionsphase Raum für sozialpolitische Innovationen auf der Provinzebene, die einem sozialdemokratischen Gesundheitssystem Vorschub leisteten. Dieses Modell blieb in seinen Grundzügen in der Rückbauphase zwar bestehen, gleichzeitig zog sich Ottawa jedoch aus der Finanzierung des Gesundheitswesens zurück.