Lecture 11: The Future Health Policy and Health Care in Canada –
Polis vs. market
Social determinants of health
Polis Versus the Market
Welfare state of community
Share risk across population
State intervention to ensure quality
o Polis is about society caring about family and it’s about equity.
o State makes sure there is access to certain goods. Aim is to
reduce poverty and inequality.
o Canada has been more of a polis than the US.
Role of political ideology – Neo-Liberalism
Minimal state role – “Freedom from government”, deregulation.
o US is a market driven society.
o High inequality.
QueenSenateHouse of Commons
Supreme Court of CanadaFederal Court of Canada
The State in Modern Society
Legislative, executive and judicial institutions.
Canada, UK: overlap between Cabinet, Parliament (Lower House),
Upper House (House of Lords UK), and Senate (Canada).
Municipal, provincial and federal governments have role in health
o All levels of government have a specific role in health. At the
municipal level it’s public health.
o Have to deal with vaccine and sanitation. Things to do if
o Delivering health care.
o Provincial and territorial governments to pay for these services.
o Provides direct services only to Aboriginals.
o It collects more money so collects more taxes and cost-sharing
health care in the provinces and territories.
o Lester B. Pearson said provincial and territorial governments
should split cost 50/50.The Welfare State: Impact on the Health of Populations
Key development in modern capitalist societies in post-WWII era
State intervention in social and health provision. E.G. health, housing,
employment insurance, public pensions.
“…a generic term for government intervention …, the welfare state can
also be seen as a capitalist society in which the state has intervened in
the form of social policies, programs, standards, and regulations in
order to mitigate class conflict and to provide for, answer, or
accommodate certain social needs for which the capitalist mode of
production in itself has no solution or makes no provision”.
o Way of ensuring equity.
Figure 13.1 Ideological Variations in Forms of the Welfare State
Found in Sweden, Denmark.