Deborah Stone: Markets and the Polis
- Contrast between political and market societies
- Market society grossly distorts political life
- Polis is the preferred political society
- In the market society there is more concern about the economic growth and see people as
maximizing their own good
- Polis is the larger community interest or collective will
- Concept of polis came from ancient Greek though; slaves of women weren’t allowed to vote;
but now there is right to vote for everyone
Key Aspect of Public Interest
- Individual vs. Collective Interests
- Impact of market and polis on health care reform
Myth: Parallel System Reduces Waiting Time
- Where do private systems doctors come from?
- Who benefits?
- Who supports it?
- Why do they support it?
- Are these issues adequately covered in public discussions? To what extent?
- What kind of solutions are being considered?
Three Major Reports on Health Care Reform
- Clair Commission (Quebec)- Emerging Solutions (Jan 2001)
- Fyke Report (Sask) – Caring for Medicare (April 2001)
- Mazankowski Report (Alta) – A Framework for Reform (Dec 2001)
- Kirby Report – The Health of Canadians –
- The Romonow Report
Three Major Reports?
- What are the main recommendations?
Mazankowski Report I
- Fundamental changes in how we should organize and deliver health care services …and… in how
we pay for health services (Exec. Summary)
- Public spending is not enough
- Direct payments by citizens
- Funding Mechanism
o User frees
o Premiums, deductibles, co-payment
o Taxing people for use
o Medical savings accounts - To see how expensive health services are
- Privately funded and delivered health services
- Supplementary or private insurance
- T o expand the private role in health care and expend services – unregulated monopoly
- Competition and choice
- Reduced coverage
- Believed that allowing a greater private role allowed for greater innovations
- Delisted services paid for privately
- “Experimental” but is it really?
- “Private innovators could do wonders for our health system”
- He wants to marketize health care more
- Commericialization and privatization
- UK experiment with privatized rail services:
- Greater r