Is Canada odd? A comparison of European and Canadian approaches to choice and regulation of the public/private divide in health care
- 1 January 2010
- journal article
- research article
- Published by Cambridge University Press (CUP) in Health Economics, Policy and Law
- Vol. 5 (3), 319-341
- https://doi.org/10.1017/s1744133110000046
Abstract
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 inChaoulli, 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 Canada truly is ‘odd’ from a comparative policy perspective by exploring regulation of choice of privately financed health care in several European countries – the Netherlands, Germany, Sweden, England and France. We highlight commonalities as well as differences, showing the extent to which these countries employ regulation to fetter growth of a large privately financed sector. The article’s thesis is that Canada, in employing more intrusive forms of regulation, is not an outlierper sebut at one point in a regulatory spectrum.Keywords
This publication has 9 references indexed in Scilit:
- Are health problems systemic? Politics of access and choice under Beveridge and Bismarck systemsHealth Economics, Policy and Law, 2010
- Did 'Targets and Terror' Reduce Waiting Times in England for Hospital Care?The B.E. Journal of Economic Analysis & Policy, 2008
- Going Dutch — Managed-Competition Health Insurance in the NetherlandsThe New England Journal of Medicine, 2007
- Consultant contract has not resulted in any increased productivityBMJ, 2007
- Does free complementary health insurance help the poor to access health care? Evidence from FranceHealth Economics, 2007
- WHAT’S MEASURED IS WHAT MATTERS: TARGETS AND GAMING IN THE ENGLISH PUBLIC HEALTH CARE SYSTEMPublic Administration, 2006
- Access to Care, Access to JusticePublished by University of Toronto Press Inc. (UTPress) ,2005
- How Does Private Finance Affect Public Health Care Systems? Marshaling the Evidence from OECD NationsJournal of Health Politics, Policy and Law, 2004
- Explaining variations in inpatient length of stay in the National Health ServiceJournal of Health Economics, 1996