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Is Two-Tier Health Care the Future?

  • Edited by: Colleen Flood and Bryan Thomas
  • With contributions by: Sara Allin , Sarah Barry , Sara Burke , Danielle Dawson , Lorraine Doetter , Stephen Duckett , Noushon Farmanara , Vanessa Gruben , Jeremiah Hurley , Martha Jackman , Bridget Johnston , Gregory Marchildon , Fiona McDonald , Rachel McKay , Jonathan Mullen , Zeynep Or , Aurélie Pierre , Amélie Quesnel-Vallée , David Rudoler , Achim Schmid , Rikke Siersbaek , Stephen Thomas and Carolyn Tuohy
Language: English
Published/Copyright: 2020
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About this book

What if Canada’s health-care system were to become a two-tier system? Would wait times be eliminated? Answering this question is critical given an ongoing Charter challenge in British Columbia.

Author / Editor information

Flood Colleen :

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.Thomas Bryan :

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.

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.

Reviews

The Canadian health care system is a source of our collective pride, but it is also in serious need of improvement. So often privatization is put forward as a solution to our challenges, with little regard for the evidence. This excellent collection offers evidence and analysis from some of our greatest thinkers on a wide variety of issues relating to 2-tier health care. A must-read for those who care about protecting and enhancing the national treasure that is Canadian Medicare.


Danielle Martin, MD

Theodore R. Marmor:
Is Two-Tier Health Care the Future?, is the best book in years about the past, present and future of Canadian Medicare. The book, with its compelling introduction by Colleen Flood and Bryan Thomas, is well written and well edited. Unlike many edited volumes, authors have written coherent, linked, chapters on the most controversial topics in Canadian medical care. These prominently include the history of intense disputes over private and public finance of hospitals and physicians, and address how and why private finance of Canadian medical care has always been and will continue to be so controversial. The most unusual feature of Canadian health care policy—illuminated by chapters on medical finance in other rich democracies—is how judicial decision making in Medicare’s past and present has become dominated by constitutional law and disputes about how much market allocation is tolerable in an egalitarian program like Canada’s Medicare. How that came to be over the past few decades and what the BC Cambie Clinic case means for the future is what this serious work of scholarship provides.

Topics

Frontmatter

Publicly Available Download PDF 		i
Table of Contents

Publicly Available Download PDF 		v
List of Figures

Publicly Available Download PDF 		vii
List of Tables

Publicly Available Download PDF 		ix
Introduction: The Courts and Two-Tier Medicare

Colleen M. Flood and Bryan Thomas
Open Access Download PDF 		1
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
Open Access Download PDF 		13
2. Chaoulli to Cambie: Charter Challenges to the Regulation of Private Care

Martha Jackman
Open Access Download PDF 		37
3. Borders, Fences, and Crossings: Regulating Parallel Private Finance in Health Care

Jeremiah Hurley
Open Access Download PDF 		69
4. Chaoulli v Quebec: Cause or Symptom of Quebec Health System Privatization?

Amélie Quesnel-Vallée, Rachel McKay and Noushon Farmanara
Open Access Download PDF 		93
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
Open Access Download PDF 		123
6. Self-Regulation as a Means of Regulating Privately Financed Medicare: What Can We Learn from the Fertility Sector?

Vanessa Gruben
Open Access Download PDF 		145
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
Open Access Download PDF 		183
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
Open Access Download PDF 		211
9. The Public-Private Mix in France: A Case for Two-Tier Health Care?

Zeynep Or and Aurélie Pierre
Open Access Download PDF 		237
10. Embracing Private Finance and Private Provision: The Australian System

Fiona McDonald and Stephen Duckett
Open Access Download PDF 		267
11. Embracing and Disentangling from Private Finance: The Irish System

Stephen Thomas, Sarah Barry, Bridget Johnston, Rikke Siersbaek and Sara Burke
Open Access Download PDF 		291
12. Contracting Our Way Around Two-Tier Care? The Use of Physician Contracts to Limit Dual Practice

Bryan Thomas
Open Access Download PDF 		315
Conclusion: The Complex Dynamics of Canadian Medicare and the Constitution

Colleen M. Flood and Bryan Thomas
Open Access Download PDF 		335
Contributors’ Biographies

Open Access Download PDF 		353
Acknowledgements

Open Access Download PDF 		359
Index

Open Access Download PDF 		361

Publishing information
Pages and Images/Illustrations in book
eBook published on:
April 28, 2020
eBook ISBN:
9780776628080
Pages and Images/Illustrations in book
Main content:
348
https://doi.org/10.1515/9780776628080
eBook ISBN: 9780776628080
Keywords for this book
Two-tier care; Universal Health Care; Canadian Charter of Rights and Freedoms
Audience(s) for this book
Professional and scholarly;
Creative Commons
BY-NC-ND 4.0
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