Econ243: Starred Article Reading Notes
Part A: Intro to Healthcare Systems:
CD Howe Institute: Rethinking Canada’s Unbalanced Mix of Public and Private Healthcare: pg. 2-
• Americans are still struggling to reach a goal we attained over 40 years ago, that every
resident should have access to healthcare systems regardless of ability to pay.
• Weve done this even though our healthcare spending is a much lower portion of our
GDP than the USA.
• We may be better than the US in some respects but compared to other countries
(Europe) we are not close to the top. (Commonwealth Fund 2014) Our low placement
partly reflects what is not covered by our provincial plans especially outpatient
• Healthcare reform has been proposed countless times but is hard to achieve for many
1) One factor is divided responsibility for healthcare financing between fed and
2) The ability of interest groups in the healthcare sector to block reforms they
perceive as threatening.
3) lack of competition between provincial healthcare insurance plans and
privately funded medicine has lessened pressure on public sector managers to improve
a low performing public system
• About 30% of Canada’s healthcare spending is privately paid for.
• Two aspects make Canada’s Public-private mix unique:
1) There is limited public coverage for items such as outpatient drugs, long term care,
dental and vision care.
2) Government pays for all physicians’ services and acute-care hospital costs.
• Elsewhere the public and private financing is mixed with more coverage in these areas
and more private financi