Access, Variation, and Reform in Canada's Provinces
2015
This article reviews the fragmentation in Canada's unique health care system, and suggests lessons useful for health care reform strategies in other nations. The author points out that complexities arise from the fact that it's a federal system that divides responsibilities between the national government (responsible for services to some Native Canadians, or First Nations and Inuit peoples), the armed forces, the Royal Canadian Mounted Police, and inmates of federal prisons, as well as some aspects of health protection), and the provinces (constitutionally responsible for everything else).
The article points out that a public system, like Canada's, that is too narrowly focused on hospital and physician care will perform poorly on many measures; even massive spending increases will not solve problems unless they are accompanied by essential policy, structural, funding, and payment reforms; and limited improvement will occur in the absence of robust service integration and shared accountability for performance supported by first-rate health information systems. Most critically, doctors have to be full partners in the system, fully engaged in charting its direction, and fully committed to improving access, quality, and efficiency.
Access, Variation, and Reform in Canada's Provinces
Source:
Lewis S. A System in Name Only—Access, Variation, and Reform in Canada's Provinces. The New England Journal of Medicine 2015; 372: 497-500. DOI: http://dx.doi.org/10.1056/NEJMp1414409.