CARLETON UNIVERSITY SCHOOL OF PUBLIC POLICY AND ADMINISTRATION PADM 5221W (ALSO PADM 4221W) HEALTH POLICY IN CANADA

Transcription

1 CARLETON UNIVERSITY SCHOOL OF PUBLIC POLICY AND ADMINISTRATION PADM 5221W (ALSO PADM 4221W) HEALTH POLICY IN CANADA Allan Maslove Winter Dunton Tower Ph: , ext 1285 Office hours: Tuesday: 10:00 noon and by appointment class meetings: Monday: 2:30 5:30 Course Objectives Health care in Canada is simultaneously an important public service, a major sector of the economy, an emotional touchstone, and more. Further, specific policies and the fundamental properties of the Canadian health care system are increasingly open to debate and challenge. This course will provide perspectives on these issues. It will begin with an overview of the basic parameters of the Canadian health care system and then move on to examine many of the challenges and major issues that are currently being debated. Prerequisite PADM 5111; PADM 5117 Course Requirements 1. Most topics will be explored through seminar discussion. For each topic 2 or 3 students will be assigned to lead the discussion and to clearly delineate the issues of debate. Students will be graded on these presentations (25% of total grade) and on general participation in the discussions (10%). 2. A research paper that explores in more depth a topic covered in the course. The topic should be cleared with me very early on in the course. The paper should identify a significant

2 current problem or potential challenge to Medicare, discuss why it is a problem, and carefully conduct an analysis and draw policy-relevant conclusions. Both political and economic dimensions of the issue should be included in your analysis. Students may write the research paper as an individual project, or two or three students may collaborate on a co-authored paper. If the paper is co-authored, the authors agree that responsibility will be shared equally and each author will receive the same grade for the paper. The individually authored papers should be in the range of pages; co-authored papers will be expected to be longer (specifics to be discussed with the instructor). (65%) Instructional Offences Academic offences are serious infractions and will not be tolerated. Students should consult Section 14 of the Faculty of Graduate Studies Calendar, General Regulations concerning instructional offences. COURSE OUTLINE AND READING LIST Readings designated with * are available through the course site on WebCT. I. The Basic Parameters of the Canadian Health Care System (sessions 1-2) Why is health care a public policy concern? Overview of the history and structure of the Canadian health care system. Canada compared to other OECD countries. *Economist, The health of nations July 17, R. G Evans, Strained Mercy: The Economics of Canadian Health Care at Senate Standing Committee on Social Affairs, Science and Technology (Kirby Report) Commission on the Future of Health Care in Canada (Romanow Report) *Colleen Flood, Profiles of Six health Care Systems. A. Blomqvist, Canadian health Care in a Global Context, C. D. Howe Institute

3 II. The Supply Side: Managing the Health Care System (sessions 3-5) Organization regional health authorities; specialized facilities Health human resources make or buy ; remuneration schemes Technology B. Chan, From Perceived Surplus to Perceived Shortage: what happened to Canada s Physician Workforce in the 1990s?, CIHI (pdf file). R-A Devlin, S. Sarma, & W. Hogg, Remunerating Primary Care Physicians: Emerging Directions and Policy Options for Canada, Healthcare Quarterly, v. 9, No. 3, *R. G. Evans 7 K. M. McGrail, Richard III, Barer-Stoddart and the Daughter of Time *M. Barer, S. Morgan & R. Evans, Strangulation or Rationalization? Costs and Access in Canadian Hospitals J. Lomas, Devolving Authority for Health Care in Canada s Provinces (4 articles) Canadian medical Assn. Journal *Bob Gardner, Local Health Integration networks: Potential challenges and Policy Directions Health council of Canada, Modernizing the Management of Health Human Resources in Canada III. The Demand Side: Challenge or Crisis? (session 6-7) Population health Population aging Particular populations immigrants; Aboriginals R. Evans, Interpreting and Addressing Inequalities in health: From Black to Acheson to Blair to...? *C. Hertzman & A. Siddiqi, tortoises 1, Hares 0: How Comparative Health Trends Between Canada and the United States Support a Long-term View of Policy and Health IV. Health System Financing (sessions 8-9) Federal-provincial arrangements User fees

4 *A. Maslove, National Goals and the Federal Role in Health Care, National Forum on Health, *A. Maslove, Health and Federal-Provincial Fiscal Arrangements: Lost Opportunity, How Ottawa Spends, *Barer, M., V. Bhatia, G.L. Stoddart, and R.G. Evans The Remarkable Tenacity of User Charges: A Concise History of the Participation, Positions, and Rationales of Canadian Interest Groups in the Debate over 'Direct Patient Participation' in Health Care Financing. Vancouver, Centre for Health Services and Policy Research, University of British Columbia. S. Abay, W. Goodman, J. Mintz, Funding Public Provision of Private Health, C. D. Howe Institute, May V. Challenges to Medicare (sessions 10-11) Wait times; Chaoulli Sustainability Privatization Coyte, P Home Care in Canada: Passing the Buck. Canadian Journal of Nursing Research 33(2), (pdf file). S. Decker & D. Remler, How Much Might Universal Health Insurance Reduce Socioeconomic Disparities in Health? A Comparison of the US and Canada C. Mustard, et. al., Paying Taxes and Using Health Care Services *M. Rachlis, Public Solutions to Health Care Wait Lists *M. Rachlis, et. al., Revitalizing Medicare: Shared problems, Public Solutions, *R. Evans, Political Wolves and Economic Sheep: The Sustainability of Public Health Insurance in Canada S. Landon, M. McMillan, et. al., Does Health Care Spending Crowd Out Other Provincial Expenditures?, Canadian Public Policy, June Supreme Court of Canada, Chaoulli Decision, 2005.

5 Premier s Advisory Council on Health For Alberta (Mazankowski), A Framework for Reform, 2001.