What's in, what's out Stakeholders': views on the boundaries of Medicare.
Published: 2006
Language: eng
Number of pages: 243
ISBN-13: 9780494219737
Description: Although there was consensus that the system should continue to be needs based but needed reform, the concept of path dependency explains why reform remains stalled. It was found that the ideas of the policy elites are "stuck" in what has been created. The ideas and interests supported the existing institutional framework that privileges the public funding of medically necessary hospital services and physician services. Policy decisions that have been made at an earlier time have limited the choices and influenced the ideas of the policy elites on what should be funded under Medicare.The sustainability of the Canadian model of health care known as Medicare is the subject of intense public debate and has focused on updating the determination of what services should be publicly funded. Provincial/territorial health insurance plans must fully cover all medically necessary hospital and/or physician services. Even though there have been numerous reports over the last few decades identifying similar themes, reform has been stalled.The objective of this thesis was to assist in the policy process by ascertaining the views of policy elites from key stakeholder groups across Canada on what should be "in" and "out" of the publicly funded system. Using a non-experimental, cross-sectional design, a self-administered questionnaire (available in both French and English) was distributed between January and April, 2002, to policy elites involved in health policy discussions, either as health providers (doctors, nurses, pharmacists, home care providers, hospital/health authorities) or as business. The results are based on 2,523 responses.The ability of government to "buy real change" will largely depend upon its ability to mediate the scope of conflict within the existing institutional framework. Even incremental changes could prove contentious, as evidenced by the views on funding insured hospital services regardless of the site of delivery. A shift to a more holistic approach that would include an expanded funding role for government could be even more contentious, as the path of the medical model is so solidly established in governmental regulations and funding frameworks. Successful reform will need to address, rather than assume, a broader view of health.
Notes: Source: Dissertation Abstracts International, Volume: 68-01, Section: B, page: 0190.

Thesis (Ph.D.)--University of Toronto, 2006.

Electronic version licensed for access by U. of T. users.