A+ Notes: Health Care
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Heard and Cohn
- at time of Confed, prov. given control over local hospitals
- feds were given resp. over most imprt issues
-prov. had constitu. resp. but no fin. ability – EI, pension
- same w/ medicare, feds aren’t invading prov. resp., rather feds welcomed
- modern reality, all issues discussed by both feds and prov.
- Can’s sys: each prov design own sys w/ funding from feds
- universality, comprehensive, accessibility, portability, public administration
- prov. already have great autonomy hard to argue for less fed involvement
- health care not possible w/o fed. ldship prov. reluctant to act
- ex. prov. allowed user fees, affecting accessibility Canada health act bans user
- health care is expensive, Ottawa needs control to maintain compet. adv.
- fed. funding allows for more equality across provs
- fed. spending powers – doesn’t interfere w/ prov. ability to legislate
- POGG – courts decided feds could pass laws in prov. jurisdiction (contradicts
- of national concern – health care & access for all is vital to Cdn society
author states criminal law as example (p 111) but just because consulted doesn’t mean
national concern – could be any issue not just health care
should feds take role in regulating or just funding? for ex, the list of essential services
•legal argument – violate constitution
•feds use spending power to regulate – ex. reduce funding for prov that allow user fees
•violates spirit of constitution – if following letter of law, but what are practical needs?
•policy argument – prov. in best pos to determine diff. health care needs and structure
of health care sys
•prov. has experience running health care sys for last 30 years
•more opp. for experimentation in ten diff. prov. rather than single national program
•for the sake of equity, need fed. role in health care, but not strong role
•philosophical argument – draw national gov’t away from more imprt issues (ie.
•nation building through health care program? same can be achieved through foreign
constitution – consider the context
I agree with 1st argument that prov do have option to make own policies if they’re willing
to forfeit fed funding
it seems prov. are all that unwilling to allow fed involvement
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