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).
About the authors
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 an associate professor in the Department of Political Science at Université Laval.
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 an associate professor in the Department of Political Science at the University of Alberta.
Other titles by Harvey Lazar
Spheres of Governance
Comparative Studies of Cities in Multilevel Governance Systems
Canadian Fiscal Arrangements
What Works, What Might Work Better
Canada: The State of the Federation 2002
Reconsidering the Institutions of Canadian Federalism
Money, Politics, and Health Care
Reconstructing the Federal-Provincial Partnership
The Impact of Global and Regional Integration on Federal Systems
Canada: The State of the Federation 2001
Canadian Political Culture(s) in Transition
Canada: The State of the Federation, 1999-2000
Toward a New Mission Statement for Canadian Fiscal Federation
Canada: The State of the Federation 1998/99
How Canadians Connect
Canada: The State of the Federation 1997
Other titles by Pierre-Gerlier Forest
The Romanow Papers
Changing Health Care in Canada
The Romanow Papers, Volume 2
The Fiscal Sustainability of Health Care in Canada
The Romanow Papers, Volume 1
The Governance of Health Care in Canada
The Romanow Papers, Volume 3