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Canada, health and historical political economy
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Journal Article
Canada, health and historical political economy
2014
Overview
Healthcare in Canada is at an important political and economic crossroads. In 2014, the 10-year Canadian Health Accord will conclude, and the role of the federal government in supporting both health research and health delivery - the latter being a responsibility of the provinces - should be the subject of intense public discussion. The 2004 Health Accord responded to a perceived crisis in the Canadian system, known as Medicare, by guaranteeing stable additional federal funding for the provinces and setting out a number of objectives oriented around quality of care. Over the next year, public figures and health experts from province to province will debate which financing models effect optimal health delivery in the face of rising, off-loaded costs. The federal government's refusal to bargain with provincial Premiers as a whole on federal funding, as well as its ongoing encouragement of 'experimentation' across provincial health systems, will increase pressure towards system transformation (Barlow and Silnicki 2012). That said, institutional practice, political culture and social resistance can make short order of reformers' attempts to alter the basic character of health delivery. This is why understanding health care delivery in historical context gives us greater insight into the system's vulnerability to change, and the extent to which the limits of reform can be assessed.
