The Governance of Health Care in Canada

by McIntosh, Tom; Forest, Pierre-Gerlier; Marchildon, Gregory P.

• ISBN13: 9780802086198
• ISBN10: 0802086195
• Format: Paperback
• Copyright: 2004-01-01
• Publisher: Univ of Toronto Pr

Summary

The twelve papers in this third volume of the research program for the Romanow Commission offer a detailed analysis of the governance of health care in Canada from the perspective of constitutionalism, intergovernmental relations, and societal context. In the first section, the authors deal with the formal division of powers regarding health care as outlined in the Canadian constitution and the Charter of Rights and Freedoms. The second section outlines the strengths and weaknesses of the intergovernmental governance of health care. Finally, the third section focuses on governance of health care outside of the governmental sphere. The theme that resonates throughout the contributions - and which is in itself a call for deeper analysis - is that health care governance has become locked in a cycle of mutual recrimination, blame assigning, and blame avoidance from the federal and provincial levels right down to the level of the individual citizen.

Author Biography

Tom McIntosh is an assistant professor in the Department of Political Science, and Research Faculty at the Saskatchewan Population Health and Evaluation Research Branch, University of Regina. Pierre-Gerlier Forest is an associate professor in the Department of Political Science at UniversitT Laval. Gregory P. Marchildon is a Canada Research Chair in Public Policy and Economic History and professor in the Faculty of Administration at the University of Regina.

Table of Contents

ACKNOWLEDGMENTS	vii
CONTRIBUTORS	ix
Introduction: Restoring Trust, Rebuilding Confidence - The Governance of Health Care and the Romanow Report	3	(22)
Tom McIntosh
Part I. The Constitutional Context
1 Health and the Distribution of Powers in Canada	25	(25)
André Braën
2 Constitutional jurisdiction over Health and Health Care Services in Canada	50	(33)
Howard Leeson
3 How Will the Charter of Rights and Freedoms and Evolving Jurisprudence Affect Health Care Costs?	83	(44)
Donna Greschner
Part II. The Intergovernmental Context
4 Intergovernmental Cooperation Mechanisms: Factors for Change?	127	(42)
Réjean Pelletier
5 Roles and Responsibilities in Health Care Policy	169	(30)
Antonia Maioni
6 Health Care Politics and the Intergovernmental Framework in Canada	199	(25)
Candace Johnson
7 The Conditions for a Sustainable Public Health System in Canada	224	(33)
Louis M. Imbeau, Kina Chenard, and Adriana Dudas
Part III. The Social and Legal Context
8 Political Elites and Their Influence on Health Care Reform in Canada	257	(23)
John N. Lavis
9 Creating a More Democratic Health System: A Critical Review of Constraints and a New Approach to Health Restructuring	280	(32)
Stephen Tomblin
10 Could New Regulatory Mechanisms Be Designed after a Critical Review of Health Technology Innovation?	312	(34)
Pascale Lehoux
11 Strengthening the Foundations: Modernizing the Canada Health Act	346
Colleen M. Flood and Sujit Choudhry