Is Two-Tier Health Care the Future? analyzes experiencesfrom across Canada, the U.S., Australia, Ireland, and France and othercountries in regulating two-tier care and from this distils policy optionsCanadian could respond with if Charter challenges to medicare are successful. Canada isfrequently portrayed as the odd-man out in significantly restricting privatefinance in public medicare. But constitutional challenges to laws protectingpublic medicare are underway. If private clinics and physician applicantssucceed in having the courts strike down laws protecting public medicare thenpolicy-makers will have a very short window of opportunity within which torespond with new laws and policies protecting Canadian medicare from extensiveprivatization. Contributorsto this volume are from law, economics, history, medicine, sociology, politicalscience and public policy. Fusing these disciplines provides a full analysis ofthe issue of how best to regulate two-tier care. Specific topicscovered include the history of private finance in Canadian medicare; ananalysis of historical and current Charter challenges to medicare; analyses ofthe regulation of two-tier care in Australia, Ireland and France and lessonsfor Canada; the economics of parallel private finance; the links between risinginequality and demand for private insurance; the ethics of queue-jumping;two-tier care in home care in Canada; self-regulation as a means of regulatingtwo-tier care; the use of physician contracts to restrict two-tier care; and asynthesis of law and policy options for regulating two-tier care in Canada.Cross-cutting themes throughout these rich, multidisciplinary chapters aredrawn out in the volumes introduction and conclusion to provide readers arobust understanding of what is at stake in the debate over whether two-tierhealth care is the future.
Recenzijos
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 policyilluminated by chapters on medical finance in other rich democraciesis how judicial decision making in Medicares past and present has become dominated by constitutional law and disputes about how much market allocation is tolerable in an egalitarian program like Canadas 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. -- Theodore R. Marmor 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
List of Figures
List of Tables
Introduction
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
Martha Jackman
3. Borders, Fences, and Crossings: Regulating Parallel Private Finance in
Health Care
Jeremiah Hurley
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?
Vanessa Gruben
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
Bryan Thomas
Conclusion
The Complex Dynamics of Canadian Medicare and the Constitution
Colleen M. Flood and Bryan Thomas
Contributors Biographies
Acknowlegments
Index
Vanessa Gruben B.Sc.H (Queens), LL.B. (Ottawa), LL.M. (Columbia) is Vice Dean (Academic), an Associate Professor at the University of Ottawa, Faculty of Common Law and a member of the Centre for Health Law, Policy and Ethics. She also leads the Ottawa Hub for Harm Reduction a multidisciplinary forum for scholars and community organizations who work on innovative harm reduction strategies. She is also co-editor of the 5th edition of Canadas leading text on health law and policy in Canada, Canadian Health Law and Policy, co-edited with Joanna Erdman and Erin Nelson (LexisNexis, 2017). Professor Gruben teaches graduate and undergraduate courses in Health Law and a seminar on Access to Health Care.
