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Why has health care reform proved a stumbling block for provincial governments across Canada? What efforts have been made to improve a struggling system, and how have they succeeded or failed? In Paradigm Freeze, experts in the field answer these fundamental questions by examining and comparing six essential policy issues - regionalization, needs-based funding, alternative payment plans, privatization, waiting lists, and prescription drug coverage - in five provinces. Noting hundreds of recommendations from dozens of reports commissioned by provincial governments over the last quarter century - the great majority to little or no avail - the book focuses on careful diagnosis, rather than unplanned treatment, of the problem. Paradigm Freeze is based on thirty case studies of policy reform in Alberta, Saskatchewan, Ontario, Quebec, and Newfoundland and Labrador. The contributors assess the nature and extent of healthcare reform in Canada since the beginning of the 1990s. They account for the generally limited extent of reform that has occurred, and identify the factors associated with the relatively few cases of large reform. An insightful new perspective on a problem that has plagued Canadian governments for decades, Paradigm Freeze is an important addition to the field of health policy. Contributors include John Church (University of Alberta), Michael Ducie (Alberta Health and Wellness), Pierre-Gerlier Forest (Pierre Elliott Trudeau Foundation), Stephen Tomblin (Memorial University), Jeff Braun Jackson (Ontario Professional Firefighters Association, Burlington, ON), Marie-Pascale Pomey (Université de Montréal), John N. Lavis (McMaster University), Harvey Lazar (Queen's University), Elisabeth Martin (Université Laval),Tom McIntosh (University of Regina), Dianna Pasic (McMaster University), Neale Smith (University of British Columbia), and Michael G. Wilson (McMaster University).
As readers of classic Russian literature know, the nineteenth century was a time of pervasive financial anxiety. With incomes erratic and banks inadequate, Russians of all social castes were deeply enmeshed in networks of credit and debt. The necessity of borrowing and lending shaped perceptions of material and moral worth, as well as notions of social respectability and personal responsibility. Credit and debt were defining features of imperial Russia’s culture of property ownership. Sergei Antonov recreates this vanished world of borrowers, bankrupts, lenders, and loan sharks in imperial Russia from the reign of Nicholas I to the period of great social and political reforms of the 1860s. Poring over a trove of previously unexamined records, Antonov gleans insights into the experiences of ordinary Russians, rich and poor, and shows how Russia’s informal but sprawling credit system helped cement connections among property owners across socioeconomic lines. Individuals of varying rank and wealth commonly borrowed from one another. Without a firm legal basis for formalizing debt relationships, obtaining a loan often hinged on subjective perceptions of trustworthiness and reputation. Even after joint-stock banks appeared in Russia in the 1860s, credit continued to operate through vast networks linked by word of mouth, as well as ties of kinship and community. Disputes over debt were common, and Bankrupts and Usurers of Imperial Russia offers close readings of legal cases to argue that Russian courts—usually thought to be underdeveloped in this era—provided an effective forum for defining and protecting private property interests.
Canada’s fragmented healthcare system is one of the most expensive among the OECD countries, yet the quality of its performance is mediocre at best. Canada lacks a system-wide healthcare strategy that brings together many individual federal, provincial, and territorial strategies into a comprehensive and coherent whole. Managing a Canadian Healthcare Strategy is a collection of ten policy research essays by leading Canadian and international scholars who address three important questions. First, if Canada had a unifying strategy, how would the country measure its success and monitor its performance? Second, who are the agents of change to bring about a Canadian system-wide strategy? Third, how can the jurisdictional realities of Canada’s political system be managed to bring about strategic reform? The final section in the volume explores ways to overcome the barriers and impediments that preoccupy Canadians’ concerns about healthcare. A companion volume to Toward a Healthcare Strategy for Canadians, the contributors to Managing a Canadian Healthcare Strategy turn to the critical importance of how necessary healthcare changes can be best implemented.
This book is the first full-scale scientific study of East Anglian English. The author is a native East Anglian sociolinguist and dialectologist who has devoted decades to the study of the speechways of Norfolk, Suffolk, Cambridgeshire and Essex. He examines their relationships to other varieties of English in Britain, as well as their contributions to the formation of American English and Southern Hemisphere Englishes.
In Remaking Policy, Carolyn Hughes Tuohy advances an ambitious new approach to understanding the relationship between political context and policy change.
While Canadians are proud of their healthcare system, the reality is that it is fragmented and disorganized. Instead of a pan-Canadian system, it is a "system of systems" - thirteen provincial and territorial systems and a federal system. As a result, Canadian healthcare has not only become one of the costliest in the world, but is falling well behind many developed countries in terms of quality. Canadians increasingly realize that their healthcare system is no longer fiscally sustainable, yet change remains elusive. The standard claim is that Canada's multijurisdictional approach makes system-wide reform nearly impossible. Toward a Healthcare Strategy for Canadians disputes this reasoning, making the case for a comprehensive, system-wide, made-in-Canada healthcare strategy. It looks at the mechanics of change and suggests ways in which the various participants in the system - governments, healthcare professionals, the private sector, and patients - can work collaboratively to transform a second-rate system. Addressing critical issues of health human resources, electronic health records, integrated care, and pharmacare, Toward a Healthcare Strategy for Canadians shows how a system-wide strategic approach to this crucial policy area can make a difference in Canada’s healthcare system in the future.
This book offers global evidence about the increasing longevity, its consequences and its potential for societal benefits. Based on statistics, academic literature, policy initiatives and numerous country experiences, it explains the interconnected effects of a longer later life, lifelong learning and more productive societies. This larger picture shows how the future can be managed by making strategic choices today. Choosing the right policies allows gaining the maximum benefits from the longevity dividend for current and future generations. This book explains how investing in lifelong learning can enrich the longevity dividend. It gives valuable insights for policy advisors, decision makers, researchers, health professionals, practitioners, students of aging and late life educators.
How will the ecological and economic crises of the 21st century transform health systems and human wellbeing?
This timely comparative study assesses the role of medical doctors in reforming publicly funded health services in England and Canada. Respected authors from health and legal backgrounds on both sides of the Atlantic consider how the high status of the profession uniquely influences reforms. With summaries of developments in models of care, and the participation of doctors since the inception of publicly funded healthcare systems, they ask whether professionals might be considered allies or enemies of policy-makers. With insights for future health policy and research, the book is an important contribution to debates about the complex relationship between doctors and the systems in which they practice.
Turning a critical eye to the health care system in Nova Scotia, Katherine Fierlbeck outlines the frameworks structuring provincial health care, while providing a detailed assessment of Nova Scotia's health financing, physical infrastructure, and service provision.