HLTC03 LECTURE 8.docx

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2 Apr 2012
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LECTURE 8
Key aspect of Public Interest
o Individual vs. collective interests
o Impact of market and polis on health care reform
Health care reforms we are looking at the impact of the markets on health care systems
Myth: parallel system reduces waiting times
o Where do private systems doctors come from?
o Who benefits?
o Who supports it?
o Why do they support it?
o Are these issues adequately covered in public discussions?
Three major reports on health care reform
o Mazankowski report
o Kirby report
He looked at health care, decided to do this out of his own interest
o Romanow report
Premier of Saskatawan. To hold a dialogue with Canadians and what it means to them
and what they want changed.
Three major reports
o What are their main recommendations?
o What are the bases of these recommendations?
o What role do ideology and values play?
o What are the implications of carrying out these policy options?
Mazankowski report 1
o Fundamental changes in how we should organize and deliver health care services…and… in
how we pay for health services
o Public spending is not enough
o Direct payments by citizens
Each year funding was increasing, so his aim was to get a handle on it. They wanted to
control it.
o Funding mechanisms
User fees
Premiums, deductibles, co-payments
Taxing people for use
Medical savings accounts
o Privately funded and delivered health services
o Supplementary or private insurance
o Expand to include role of private sector "unregulated monopoly"
o Competition and choice
o Reduce coverage
o Delisted services paid for privately
o Experimental but is it really?
o Private innovators could do wonders for our health care system
o Commercialization and privatization
Wanted to marketize health care
o UK experiment with privatized rail services:
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