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Medical Health Policy

Paradigm Freeze

Why It Is So Hard to Reform Health Care in Canada

edited by Harvey Lazar, Pierre-Gerlier Forest, John N. Lavis & John Church

McGill-Queen's University Press
Initial publish date
Oct 2013
Health Policy
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    Oct 2013
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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.

Harvey Lazar's profile page

Pierre-Gerlier Forest is an associate professor in the Department of Political Science at Université Laval.

Pierre-Gerlier Forest's profile page

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 N. Lavis' profile page

John Church is an associate professor in the Department of Political Science at the University of Alberta.

John Church's profile page

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