7. Delivering Health Care: Public, Not-for-Profit, or Private?

Deber, Raisa; Forest, Pierre-Gerlier; Marchildon, Gregory P.; McIntosh, Tom

doi:10.3138/9781442681286-010

Cited by 25 publications

(35 citation statements)

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“…The literature suggests that not-for-profit providers have a better record of providing services in the interest of clients if this requires going beyond the precise terms specified in contracts (Deber 2004). When measurability is low, this willingness to do more can produce superior outcomes.…”

Section: Bc) • What Is Incorporated In the Delivery Model?mentioning

confidence: 99%

“…As Alan Hudson noted in his presentation, additional capacity can come either from existing providers operating more efficiently or from new ones, which in turn suggests something about how easy and desirable it is for new providers to enter the market and old ones to exit it. Clarifying where strategic purchasing might work thus leads to the need to examine what economists term contestability, measurability and complexity (Deber 2004;Preker and Harding 2000).…”

Section: Bc) • What Is Incorporated In the Delivery Model?mentioning

confidence: 99%

See 1 more Smart Citation

Thoughts on the Day: Strategic Purchasing and Equity

Deber¹,

Lewis²

2007

hcpap

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Section: Bc) • What Is Incorporated In the Delivery Model?mentioning

confidence: 99%

Section: Bc) • What Is Incorporated In the Delivery Model?mentioning

confidence: 99%

Thoughts on the Day: Strategic Purchasing and Equity

Deber¹,

Lewis²

2007

hcpap

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“…The fourth is evident in private care centres' lobbying for, on the one hand, private insurance to cover their services and, on the other, contracts with the health authorities to treat public patients with public funds, putatively to shorten waiting times for all publicly insured patients. As predicted (Deber 2002), once established the Canadian private care providers formed political coalitions to defend and increase their share of funding. Not surprisingly, 14 private treatment centres, the majority from British Columbia and most of them recipients of WCB funding, were intervenors in Chaoulli v. Quebec.…”

Section: Workers' Compensation Boards and Private Care In Canadamentioning

confidence: 99%

Under the Radar: Stealth Development of Two-Tier Healthcare in Canada

Davidson

2006

hcpol

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The shocked reaction of commentators to the recent Canadian Supreme Court decision (Chaoulli v. Quebec) overturning Quebec' s ban on private healthcare insurance is difficult to square with the facts and policy options realistically open to provincial governments. The problem is that rhetoric has centred on preserving a single-tier universal system that has never existed in the form its supporters imagine. Meanwhile, quasi-private agencies and healthcare entrepreneurs have been improvising private care options, either ignored or abetted by governments. Consequently, policy and practice have become increasingly divergent. Supporters of Canadian-style medicare can only hope that the Chaoulli decision will force clearer-headed policy re-appraisal. Towards that end, this paper argues that provincial governments ought to focus more on robust regulation of already existing, privately financed healthcare, including the commissioning of care by Workers' Compensation Boards.

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“…1,2 The CHA has become a paradox in Canada's health care landscape: some perceive it as a protector of the nation's single-payer, publicly funded and privately-delivered health care system; 3,4 at the same time, others view it as an institutional barrier to developing a more progressive health system that meets the current needs of Canadians. 5,6 As might be predicted, stakeholders and political pressure groups use the language of the CHA, and their perception of its intent, to defend their particular ideologies against other competing interests.…”

Section: Introductionmentioning

confidence: 99%

“…4,7,8 However, it is essential to note that the CHA defines the terms and conditions of an ''insured'' service across all Canadian jurisdictions. For instance, the ''comprehensiveness'' condition defines an insured service in terms of who delivers it and where it is delivered.…”

Section: Introductionmentioning

confidence: 99%

Availability and Structure of Ambulatory Rehabilitation Services: A Survey of Hospitals with Designated Rehabilitation Beds in Ontario, Canada

Landry

Passalent

Cott³

2008

Physiotherapy Canada

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Purpose: To determine the degree to which ambulatory physical therapy (PT), occupational therapy (OT), and speech language pathology (SLP) services are available in hospitals with designated rehabilitation beds (DRBs) in Ontario, and to explore the structure of delivery and funding among services that exist. Methods: Questions regarding ambulatory services were included in the System Integration and Change (SIC) survey sent to all hospitals participating in the Hospital Report 2005: Rehabilitation initiative. Results: The response rate was 75.9% (41 of 54 hospitals). All hospitals surveyed provide some degree of ambulatory rehabilitation services, but the nature of these services varies according to rehabilitation client groups (RCGs). The majority of hospitals continue to deliver services through their employees rather than by contracting out or by creating for-profit subsidiary clinics, but an increasing proportion is accessing private sources to finance ambulatory services. Conclusions: Most hospitals with DRBs provide some degree of ambulatory rehabilitation services. Privatization of delivery is not widespread in these facilities.Key Words: access, ambulatory services, hospitals, hospital report card, rehabilitation RÉ SUMÉObjet : Dé terminer le degré de disponibilité des soins ambulatoires de physiothé rapie, d'ergothé rapie et d'orthophonie dans les hô pitaux ayant des lits de ré adaptation dé signé s en Ontario ; explorer la structure de prestation et de financement des soins offerts. Me´thodologie : Des questions concernant les soins ambulatoires ont é té incluses dans le sondage sur l'inté gration et le changement du systè me qui a é té envoyé à tous les hô pitaux participants dans le cadre du Rapport de 2005 sur les hoˆpitaux : Re´adaptation. Re´sultats : Le taux de ré ponse a é té de 75,9 % (41 des 54 hô pitaux). Tous les hô pitaux sondé s assurent la prestation de soins ambulatoires de ré adaptation à un certain degré , mais la nature de ces soins varie selon le groupe client en ré adaptation. La majorité des hô pitaux continue d'assurer la prestation de soins par l'intermé diaire de leurs employé s plutô t que de recourir à des sous-traitants ou de cré er des cliniques subsidiaires à but lucratif, mais une proportion croissante accè de à des sources privé es pour le financement des soins ambulatoires. Conclusion : La plupart des hô pitaux ayant des lits de ré adaptation dé signé s fournissent des soins de ré adaptation ambulatoires à un certain degré . La privatisation de la prestation n'est pas trè s é tendue à ces installations.

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7. Delivering Health Care: Public, Not-for-Profit, or Private?

Cited by 25 publications

References 0 publications

Thoughts on the Day: Strategic Purchasing and Equity

Thoughts on the Day: Strategic Purchasing and Equity

Under the Radar: Stealth Development of Two-Tier Healthcare in Canada

Availability and Structure of Ambulatory Rehabilitation Services: A Survey of Hospitals with Designated Rehabilitation Beds in Ontario, Canada

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