Paradigm Freeze: Why It Is So Hard to Reform Health Care in Canada
Why has health care reform proved a stumbling block for provincial governments across Canada? What efforts have been made to improve a struggling system, and how have they succeeded or failed? In Paradigm Freeze, experts in the field answer these fundamental questions by examining and comparing six essential policy issues - regionalization, needs-based funding, alternative payment plans, privatization, waiting lists, and prescription drug coverage - in five provinces. Noting hundreds of recommendations from dozens of reports commissioned by provincial governments over the last quarter century - the great majority to little or no avail - the book focuses on careful diagnosis, rather than unplanned treatment, of the problem. Paradigm Freeze is based on thirty case studies of policy reform in Alberta, Saskatchewan, Ontario, Quebec, and Newfoundland and Labrador. The contributors assess the nature and extent of healthcare reform in Canada since the beginning of the 1990s. They account for the generally limited extent of reform that has occurred, and identify the factors associated with the relatively few cases of large reform. An insightful new perspective on a problem that has plagued Canadian governments for decades, Paradigm Freeze is an important addition to the field of health policy. Contributors include John Church (University of Alberta), Michael Ducie (Alberta Health and Wellness), Pierre-Gerlier Forest (Pierre Elliott Trudeau Foundation), Stephen Tomblin (Memorial University), Jeff Braun Jackson (Ontario Professional Firefighters Association, Burlington, ON), Marie-Pascale Pomey (Université de Montréal), John N. Lavis (McMaster University), Harvey Lazar (Queen's University), Elisabeth Martin (Université Laval),Tom McIntosh (University of Regina), Dianna Pasic (McMaster University), Neale Smith (University of British Columbia), and Michael G. Wilson (McMaster University).
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Paradigm Freeze: Why It Is So Hard to Reform Health Care in Canada
Why has health care reform proved a stumbling block for provincial governments across Canada? What efforts have been made to improve a struggling system, and how have they succeeded or failed? In Paradigm Freeze, experts in the field answer these fundamental questions by examining and comparing six essential policy issues - regionalization, needs-based funding, alternative payment plans, privatization, waiting lists, and prescription drug coverage - in five provinces. Noting hundreds of recommendations from dozens of reports commissioned by provincial governments over the last quarter century - the great majority to little or no avail - the book focuses on careful diagnosis, rather than unplanned treatment, of the problem. Paradigm Freeze is based on thirty case studies of policy reform in Alberta, Saskatchewan, Ontario, Quebec, and Newfoundland and Labrador. The contributors assess the nature and extent of healthcare reform in Canada since the beginning of the 1990s. They account for the generally limited extent of reform that has occurred, and identify the factors associated with the relatively few cases of large reform. An insightful new perspective on a problem that has plagued Canadian governments for decades, Paradigm Freeze is an important addition to the field of health policy. Contributors include John Church (University of Alberta), Michael Ducie (Alberta Health and Wellness), Pierre-Gerlier Forest (Pierre Elliott Trudeau Foundation), Stephen Tomblin (Memorial University), Jeff Braun Jackson (Ontario Professional Firefighters Association, Burlington, ON), Marie-Pascale Pomey (Université de Montréal), John N. Lavis (McMaster University), Harvey Lazar (Queen's University), Elisabeth Martin (Université Laval),Tom McIntosh (University of Regina), Dianna Pasic (McMaster University), Neale Smith (University of British Columbia), and Michael G. Wilson (McMaster University).
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Paradigm Freeze: Why It Is So Hard to Reform Health Care in Canada

Paradigm Freeze: Why It Is So Hard to Reform Health Care in Canada

Paradigm Freeze: Why It Is So Hard to Reform Health Care in Canada

Paradigm Freeze: Why It Is So Hard to Reform Health Care in Canada

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Overview

Why has health care reform proved a stumbling block for provincial governments across Canada? What efforts have been made to improve a struggling system, and how have they succeeded or failed? In Paradigm Freeze, experts in the field answer these fundamental questions by examining and comparing six essential policy issues - regionalization, needs-based funding, alternative payment plans, privatization, waiting lists, and prescription drug coverage - in five provinces. Noting hundreds of recommendations from dozens of reports commissioned by provincial governments over the last quarter century - the great majority to little or no avail - the book focuses on careful diagnosis, rather than unplanned treatment, of the problem. Paradigm Freeze is based on thirty case studies of policy reform in Alberta, Saskatchewan, Ontario, Quebec, and Newfoundland and Labrador. The contributors assess the nature and extent of healthcare reform in Canada since the beginning of the 1990s. They account for the generally limited extent of reform that has occurred, and identify the factors associated with the relatively few cases of large reform. An insightful new perspective on a problem that has plagued Canadian governments for decades, Paradigm Freeze is an important addition to the field of health policy. Contributors include John Church (University of Alberta), Michael Ducie (Alberta Health and Wellness), Pierre-Gerlier Forest (Pierre Elliott Trudeau Foundation), Stephen Tomblin (Memorial University), Jeff Braun Jackson (Ontario Professional Firefighters Association, Burlington, ON), Marie-Pascale Pomey (Université de Montréal), John N. Lavis (McMaster University), Harvey Lazar (Queen's University), Elisabeth Martin (Université Laval),Tom McIntosh (University of Regina), Dianna Pasic (McMaster University), Neale Smith (University of British Columbia), and Michael G. Wilson (McMaster University).

Product Details

ISBN-13: 9781553393382
Publisher: McGill-Queens University Press
Publication date: 10/24/2013
Series: Queen's Policy Studies Series , #179
Sold by: Barnes & Noble
Format: eBook
File size: 3 MB

About the Author

Harvey Lazar is adjunct professor in the School of Public Administration at the University of Victoria and a fellow at the Institute of Intergovernmental Relations at Queen's University.

Pierre-Gerlier Forest is president of the Pierre Elliott Trudeau Foundation.

John N. Lavis is professor, Department of Clinical Epidemiology and Biostatistics, director, McMaster Health Forum, and associate director, Centre for Health Economics and Policy Analysis, McMaster University.

John Church is associate professor, Department of Political Science, University of Alberta.


Harvey Lazar is fellow, Institute of Intergovernmental Relations, Queen's University, and senior research associate, Centre for Global Studies, University of Victoria.

Table of Contents

List of Tables and Figures v

Foreword vii

Preface ix

Glossary xi

Abbreviations xv

Chapter 1 Why Is It So Hard to Reform Health-Care Policy in Canada? Harvey Lazar 1

Chapter 2 Studying Health-Care Reforms John N. Lavis 21

Chapter 3 Health Reform in Alberta: Fiscal Crisis, Political Leadership, and Institutional Change within a Single-Party Democratic State John Church Neale Smith 35

Chapter 4 Saskatchewan's Health-Care Policy Reform in the Romanow Era: From Restraint to Restructuring Tom McIntosh Michael Ducie 65

Chapter 5 Health-Care Reform in Ontario: More Tortoise Than Hare? John N. Lavis Dianna Pasic Michael G. Wilson 89

Chapter 6 Quebec Reforms from Rochon to Couillard: The Long and Winding Road Marie-Pascale Pomey Elisabeth Martin Pierre-Gerlier Forest 113

Chapter 7 Between a Rock and a Hard Place: The Difficulty of Reforming Health Care in Newfoundland and Labrador Stephen G. Tomblin Jeff Braun-Jackson 147

Chapter 8 Canadian Health-Care Reform: What Kind? How Much? Why? Harvey Lazar Pierre-Gerlier Forest John N. Lavis John Church 171

Chapter 9 Patterns in the Factors That Explain Health-Care Policy Reform Harvey Lazar John Church 219

Chapter 10 Verifying the Reliability of Research Results Harvey Lazar John Church 253

Chapter 11 Health-Care Reform: Where Things Stand Harvey Lazar 283

Chapter 12 Prospects for Health-Care Policy Reform Harvey Lazar Pierre-Gerlier Forest 307

Annex 1 Analyzing the Nature and Extent of Health-Care Policy Reforms, 1990-2003 Harvey Lazar 331

Annex 2 Independent Variables Referred to in 30 Case Studies That Best Help to Explain Nature and Extent of Reforms Harvey Lazar Julia Diamond 353

Annex 3 Some Observations on the Historical Development of Medicare Harvey Lazar 371

References 375

Contributors 397

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