This paper analyzes the debates surrounding the privatization of health services financing in quebec. The objective is to clarify policy-making processes with regard to this important issue and, more generally, to provide a realistic understanding of health-related policy processes in Canada. The analysis is based on a large and continuous sample of mass media and National Assembly debates on the question during the four-and-a-half years following the Chaoulli ruling of the Supreme Court of Canada. These data are used to test four hypotheses about relationships among the types of political actors involved, their policy preferences, the rhetoric they use and the anticipated policy effects they assert. The results are applied to a discussion of questions about the factors that influence the effectiveness of political communication.
RésuméCet article fait l' analyse du débat autour de la privatisation du financement des services de santé au québec. L' objectif est de clarifier les processus d' élaboration de politiques quant à cet enjeu d'importance et, de façon plus générale, de mieux comprendre le processus d' élaboration des politiques de santé au Canada. L' analyse se fonde sur un vaste échantillon continu provenant des médias de masse et des débats sur le sujet à l' Assemblée nationale au cours des quatre années et demie qui ont suivi la décision de la Cour suprême du Canada sur l' affaire Chaoulli. Ces données ont servi à tester quatre hypothèses au sujet de la relation entres les types d' acteurs politiques impliqués, leurs préférences politiques, leur discours et les effets qu'ils attribuent aux différentes options politiques. Les résultats sont utilisés pour discuter des facteurs qui influencent l' efficacité des communications politiques. (Béland et al. 2008; Castonguay 2008; Contandriopoulos and Bilodeau 2008). In June 2005, in a very close four-against-three majority, the Supreme Court of Canada (2005) ruled in Chaoulli v. Quebec that the prohibition of substitutive private insurance for medically necessary services available under medicare in quebec violated quebec' s charter of rights (flood et al. 2005; maioni and manfredi 2005). However, it soon became clear that the effects of that ruling were not so much legal as political. The ruling opened a policy window (kingdon 1984) prompted by a strong surge in the overall salience of the issue, resulting in related legislative activities (Castonguay 2008; Government of quebec 2006a Government of quebec ,b, 2008. In this paper, we use the postChaoulli healthcare financing policy debate as a revelatory case study to understand healthrelated policy processes in quebec and Canada.Our analysis is based on a large and continuous sample of the publicly observable components of policy-making processes during a four-and-a-half-year period. The data were used to test four hypotheses regarding the interdependence of groups' preferences, policy options supported, rhetoric used and anticipated effects. We then compared our results against the evolution of ...