Canadians are deeply worried about wait times for health care. Entrepreneurial doctors and private clinics are bringing Charter challenges to existing laws restrictive of a two-tier system. They argue that Canada is an outlier among developed countries in limiting options to jump the queue.
This book explores whether a two-tier model is a solution.
In Is Two-Tier Health Care the Future?, leading researchers explore the public and private mix in Canada, Australia, Germany, France, and Ireland. They explain the history and complexity of interactions between public and private funding of health care and the many regulations and policies found in different countries used to both inhibit and sometimes to encourage two-tier care, such as tax breaks.
This edited collection provides critical evidence on the different approaches to regulating two-tier care across different countries and what could work in Canada.
This book is published in English.
Colleen M. Flood FRSC is a University of Ottawa Research Chair in Health Law & Policy and inaugural director of the Ottawa Centre for Health Law, Policy and Ethics. From 2017-2018 she served as Associate Vice-President Research at the University of Ottawa. From 2000-2015 she was a Professor and Canada Research Chair at the Faculty of Law, University of Toronto with cross-appointments to the School of Public Policy and the Institute of Health Policy, Management & Evaluation. From 2006-2011 she served as a Scientific Director of the Institute for Health Services and Policy Research, one of the Canadian Institutes of Health Research.
Bryan Thomas is Senior Research Fellow with the Centre for Health Law, Policy and Ethics and Adjunct Professor with the Faculty of Law, University of Ottawa. His research spans a wide range of topics including Canadian and comparative health law and policy, health rights litigation, long-term care, global health law, and the role of religious argument in legal and political discourse. Dr. Thomas holds an SJD from University of Toronto and a Master's degree in Philosophy from Dalhousie.
List of Figures
List of Tables
The Courts and Two-Tier Medicare
Colleen M. Flood and Bryan Thomas
Part I: The Context and Contestations of Public and Private in the Canadian Health Care System
1. Private Finance and Canadian Medicare: Learning from History
Gregory P. Marchildon
2. Chaoulli to Cambie: Charter Challenges to the Regulation of Private Care
3. Borders, Fences, and Crossings: Regulating Parallel Private Finance in Health Care
4. Chaoulli v Quebec: Cause or Symptom of Quebec Health System Privatization?
Amélie Quesnel-Vallée, Rachel McKay, and Noushon Farmanara
5. Experiences with Two-Tier Home Care in Canada: A Focus on Inequalities in Home Care Use by Income in Ontario
Sara Allin, David Rudoler, Danielle Dawson, and Jonathan Mullen
6. Self-Regulation as a Means of Regulating Privately Financed Medicare: What Can We Learn from the Fertility Sector?
Part II: Is Canada Odd? Looking at the Regulation of Public/Private Mix of Health Care in Other Countries
7. The Politics of Market-Oriented Reforms: Lessons from the United Kingdom, the United States, and the Netherlands
Carolyn Hughes Tuohy
8. The Public-Private Mix in Health Care: Reflections on the Interplay between Social and Private Insurance in Germany
Achim Schmid and Lorraine Frisina Doetter
9. The Public-Private Mix in France: A Case for Two-Tier Health Care?
Zeynep Or and Aurélie Pierre
10. Embracing Private Finance and Private Provision: The Australian System
Fiona McDonald and Stephen Duckett
11. Embracing and Disentangling from Private Finance: The Irish System
Stephen Thomas, Sarah Barry, Bridget Johnston, Rikke Siersbaek, and Sara Burke
12. Contracting Our Way Around Two-Tier Care? The Use of Physician Contracts to Limit Dual Practice
The Complex Dynamics of Canadian Medicare and the Constitution
Colleen M. Flood and Bryan Thomas