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<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> <html> <head><script type="text/javascript" src="/_static/js/bundle-playback.js?v=HxkREWBo" charset="utf-8"></script> <script type="text/javascript" src="/_static/js/wombat.js?v=txqj7nKC" charset="utf-8"></script> <script>window.RufflePlayer=window.RufflePlayer||{};window.RufflePlayer.config={"autoplay":"on","unmuteOverlay":"hidden"};</script> <script type="text/javascript" src="/_static/js/ruffle/ruffle.js"></script> <script type="text/javascript"> __wm.init("https://web.archive.org/web"); __wm.wombat("http://www.irpp.org:80/po/archive/po0500.htm","20050503085249","https://web.archive.org/","web","/_static/", "1115110369"); </script> <link rel="stylesheet" type="text/css" href="/_static/css/banner-styles.css?v=S1zqJCYt" /> <link rel="stylesheet" type="text/css" href="/_static/css/iconochive.css?v=3PDvdIFv" />  <title>po0500.htm</title> </head> <body bgcolor="#FFFFFF" text="#000000" link="003399" vlink="#FF9900" alink="003399"> <a name="Index"></a> <table width="500" cellspacing="0" cellpadding="0" border="0"> <tr> <td><img src="/web/20050503085249im_/http://www.irpp.org/po/images/covers/po0500l.gif" border="0" alt="Policy Options"></td> <td><ul type="square"> <img src="/web/20050503085249im_/http://www.irpp.org/po/images/po0500t.gif" border="0" alt=""> <img src="/web/20050503085249im_/http://www.irpp.org/po/images/po1-r2.gif" border="0" alt="Policy Options"> <img src="/web/20050503085249im_/http://www.irpp.org/images/spacer.gif" align="left" width="30" height="20" border="0"><img src="/web/20050503085249im_/http://www.irpp.org/po/images/po0500d.gif" border="0" alt=""> <a href="/web/20050503085249/http://www.irpp.org/po/po_home.htm" target="_self" style="text-indent: 55 px; text-decoration: none; font-weight: bold; color: CC0000"><li>current issue</a> <a href="/web/20050503085249/http://www.irpp.org/po/po_arc.htm" target="_self" style="text-indent: 55 px; text-decoration: none; font-weight: bold; color: CC0000"><li>other back issues</a> <a href="/web/20050503085249/http://www.irpp.org/po/po_order.htm" target="_self" style="text-indent: 55 px; text-decoration: none; font-weight: bold; color: CC0000"><li>to order</a> </ul> </td> </tr> </table></div>   <table width="500" cellspacing="2" cellpadding="2" border="0"> <tr> <td> <ul type="square"> <li>William Watson, <a href="#watson" style="text-decoration: none;">"From the editor's desktop"</a> HOW I'D FIX HEALTH CARE <li>Monique B間in, <a href="#health" style="text-decoration: none;">"How I'd fix health care"</a> <li>Claude E. Forget, <a href="#health" style="text-decoration: none;">"What is ailing Canada's health system?"</a> <li>Fred McMahon, <a href="#health" style="text-decoration: none;">"Public funding with market dynamics"</a> <li>Stephen Cord, <a href="#health" style="text-decoration: none;">"Make patients fiscally responsible"</a> <li>Pierre-Yves Cr閙ieux and Pierre Ouellette, <a href="#health" style="text-decoration: none;">"Diagnosing the illness"</a> <li>David Gratzer, <a href="#health" style="text-decoration: none;">"Don't fix health care: Free it"</a> <li>Pierre-Gerlier Forest, <a href="#health" style="text-decoration: none;">"Il faut voir comment on nous parle..."</a> <li>Colleen M. Flood, <a href="#health" style="text-decoration: none;">"Accountability, flexibility, and integration"</a> <li>Raghu Venugopal and Rajeev Venugopal, <a href="#health" style="text-decoration: none;">"How we'd fix health care"</a> <li>Patricia O'Reilly, <a href="#health" style="text-decoration: none;">"How to (help) fix (part of) the health-care system"</a> <a href="#past" style="text-decoration: none;"><li>20 years of health care in Policy Options</a> <li>Mark Kennedy, <a href="#kennedy" style="text-decoration: none;">"Some unsolicted advice for health ministers"</a> <li>Gregg Easterbrook, <a href="#easterbrook" style="text-decoration: none;">"Managing fine: How to love the HMO"</a> <li>Shainoor N. Virani, Mebs S. Kanji and Barry Cooper, <a href="#virani" style="text-decoration: none;">"Why Bill 11 won't hurt Ralph Klein"</a> ASSESSING THE SOCIAL UNION FRAMEWORK AGREEMENT, REDUX <li>Ross Finnie, <a href="#sufa" style="text-decoration: none;">"Interprovincial mobility and the SUFA"</a> <li>Alain No雔, <a href="#sufa" style="text-decoration: none;">"Collaborative federalism - with a footnote"</a> <li>Herman Bakvis and David M. Cameron, <a href="#sufa" style="text-decoration: none;">"Post-secondary education and the SUFA"</a> <li>Jane Jenson, <a href="#sufa" style="text-decoration: none;">"Reading the SUFA through policies for children: Towards a new citizenship regime"</a> <li>Christopher Dunn, <a href="#sufa" style="text-decoration: none;">"FYI: SUFA? DOA"</a> PLUS <li>M.J. Gordon, <a href="#gordon" style="text-decoration: none;">"Why foreign ownership is a problem - and what to do about it"</a> <li>Aaron Freeman, <a href="#freeman" style="text-decoration: none;">"Make EDC respect human rights and the environment"</a> <li>Antonio R. Gualtieri, <a href="#gualtieri" style="text-decoration: none;">"Should God be in the Canadian constitution?"</a> <li>Alan S. Alexandroff, <a href="#alexandroff" style="text-decoration: none;">"The WTO's China problem"</a> </td> </tr> </table> <table width="500" cellspacing="2" cellpadding="2" border="0"> <tr> <td> <hr> <a name="watson">William Watson, "From the editor's desktop"</a> Sorry, the summary of this article is not available. <center><a href="may00/watson.pdf" style="text-decoration: none">download article (PDF)</a> | <a href="#Index" style="text-decoration: none">return to index</a></center><hr> <a name="health">"How I'd fix health care"</a> If there is a consensus on anything in the Canadian health care system - and there probably isn't - it is that the status quo no longer works. But if it doesn't, what would? We asked 10 Canadians who spend much of their time thinking about the health care system to tell us how they'd fix it. Here's what they wrote. Monique B間in, "How I'd fix health care" Claude E. Forget, "What is ailing Canada's health system?" Fred McMahon, "Public funding with market dynamics" Stephen Cord, "Make patients fiscally responsible" Pierre-Yves Cr閙ieux and Pierre Ouellette, "Diagnosing the illness" David Gratzer, "Don't fix health care: Free it" Pierre-Gerlier Forest, "Il faut voir comment on nous parle..." Colleen M. Flood, "Accountability, flexibility, and integration" Raghu Venugopal and Rajeev Venugopal, "How we'd fix health care" Patricia O'Reilly, "How to (help) fix (part of) the health-care system" <center><a href="may00/health.pdf" style="text-decoration: none">download articles (PDF)</a> | <a href="#Index" style="text-decoration: none">return to index</a></center><hr> <a name="past">20 years of health care in Policy Options</a> This year marks Policy Options' 20th anniversary. To celebrate, we are running excerpts from the archives. In this issue, to go along with our cover story, we feature past analysis of and recommendations for health care policy. Lots has changed in 20 years, but, alas!, as you'll see, lots hasn't. Contributions by Ruben Bellan, Daniel Cappon, David Conklin, Anne Crichton, John Church, Susi M. Derrah, Ronald Labonte, Malgorzata Figurska and Jacek Holowka, Robert G. Evans, Morris Barer and Greg Stoddart, Ron Marston, Kenneth J. Fyke and Barbara Poole, Maureen A. Maloney, William G. Tholl and Claudia A. Sanmartin, Douglas J. McCready, Louis B. Sherman. <center><a href="may00/past.pdf" style="text-decoration: none">download article (PDF)</a> | <a href="#Index" style="text-decoration: none">return to index</a></center><hr> <a name="kennedy">Mark Kennedy, "Some unsolicted advice for health ministers"</a> One of the few Canadian journalists who follows health care full time offers some unsolicited advice to the country's health ministers about their annual meetings: Stop claiming you're making progress when you aren't. Spend more time together every year. Bring in experts from outside government when you do meet. And please, please stop wrapping yourself in the flag of the Canada Health Act - which your collective expressions of devotion to have turned into an essentially empty symbol. <center><a href="may00/kennedy.pdf" style="text-decoration: none">download article (PDF)</a> | <a href="#Index" style="text-decoration: none">return to index</a></center><hr> <a name="easterbrook">Gregg Easterbrook, "Managing fine: How to love the HMO"</a> For 35 years, Canadians have defined their health care system mainly in terms of what it is not: the US model. But, these days, what is the US model? In this reprint from the March 20, 2000 issue of The New Republic, Senior Editor Gregg Easterbrook provides an update on the Health Maintenance Organization, the institutional device that now dominates US health care. Although the US system still does not provide universal health insurance, Easterbrook argues that HMOs have done a remarkable job of controlling health care costs, and are not quite as ruthless in walking away from their contractual obligations as is often thought. <center><a href="may00/easterbr.pdf" style="text-decoration: none">download article (PDF)</a> | <a href="#Index" style="text-decoration: none">return to index</a></center><hr> <a name="virani">Shainoor N. Virani, Mebs S. Kanji and Barry Cooper, "Why Bill 11 won't hurt Ralph Klein"</a> The Klein government's recent proposal, in Bill 11, to contract out minor surgical services to private health facilities has added fuel to an already heated debate about health care. Public opinion survey results suggest that Albertans' primary health concern is accessibility to services, and that views about funding are secondary. Support for private clinics fell between 1995 and 1999 but the threat of privatization remains a tertiary concern: Albertans worry less about who provides health care and more about its being easily accessible. Concerns over health care restructuring do have a negative impact on support for the government, but the popularity of maintaining a balanced budget counters that effect. This suggests Albertans may be willing to trade the pain of health care restructuring for the gain of economic sustainability. <center><a href="may00/virani.pdf" style="text-decoration: none">download article (PDF)</a> | <a href="#Index" style="text-decoration: none">return to index</a></center><hr> <a name="sufa">"The Social Union Framework Agreement, redux"</a> In February, the IRPP and the Saskatchewan Institute of Public Policy sponsored a major conference on the Social Union Framework Agreement, or SUFA, which came into being a year earlier. Participants analysed the agreement from several different perspectives. In the last issue of Policy Options, we presented summaries of six presentations (from Antonia Maioni, Pierre-Gerlier Forest, Matthew Mendelsohn and John McLean, Michael J. Prince, Gerard Boychuk and Tom McIntosh). In this issue, we present five more. Ross Finnie, "Interprovincial mobility and the SUFA" Alain No雔, "Collaborative federalism - with a footnote" Herman Bakvis and David M. Cameron, "Post-secondary education and the SUFA" Jane Jenson, "Reading the SUFA through policies for children: Towards a new citizenship regime" Christopher Dunn, "FYI: SUFA? DOA" <center><a href="may00/sufa.pdf" style="text-decoration: none">download articles (PDF)</a> | <a href="#Index" style="text-decoration: none">return to index</a></center><hr> <a name="gordon">M.J. Gordon, "Why foreign ownership is a problem - and what to do about it"</a> In recent months, concern has been expressed in some surprising quarters about the possibly harmful effects of foreign investment on the Canadian economy. A major difficulty in making public policy regarding such corporations is that we know hardly anything about them: Wholly-owned subsidiaries are not obliged to file financial statements. Two modest policy changes are called for: Any corporation with sales greater than $1 million should be required to publish full financial statements, and Statistics Canada should publish separate data series for Canadian and foreign-owned corporations. <center><a href="may00/gordon.pdf" style="text-decoration: none">download article (PDF)</a> | <a href="#Index" style="text-decoration: none">return to index</a></center><hr> <a name="freeman">Aaron Freeman, "Make EDC respect human rights and the environment"</a> As official government assistance to developing countries has declined, export credit agencies such as Canada's Export Development Corporation (EDC) have become increasingly important. At the moment, the EDC is exempt from the sorts of environmental and human rights standards that apply both to other Canadian agencies and to agencies in other countries, including the United States. As the government reviews the act governing the EDC, it should raise the standards the Corporation must meet in making its loans. <center><a href="may00/freeman.pdf" style="text-decoration: none">download article (PDF)</a> | <a href="#Index" style="text-decoration: none">return to index</a></center><hr> <a name="gualtieri">Antonio R. Gualtieri, "Should God be in the Canadian constitution?"</a> God is currently in the Constitution, in the preamble to the Charter of Rights and Freedoms. Humanists want Him out. If the constitutional reference were to the particularist Christian God, their concern would be justified. But belief in God implies a belief in several other things that are in fact logical preconditions for a constitutional order, among them: the existence of a reality that is independent of ourselves and our desires; the objectivity of moral values; the orderedness of the world; and, finally, our inability to achieve the perfection of our visions. God should therefore stay. <center><a href="may00/gualtier.pdf" style="text-decoration: none">download article (PDF)</a> | <a href="#Index" style="text-decoration: none">return to index</a></center><hr> <a name="alexandroff">Alan S. Alexandroff, "The WTO's China problem"</a> Whether China gets "permanent normal trading relations" from the US looks like being a close run thing. On the other hand, its admission to the WTO finally seems all but certain. The agreements that will make this possible, including the China-US bilateral negotiated last fall, provide for quite sweeping reforms of China's economy and legal system. It is not yet clear, however, whether the Chinese government will be willing or able to deliver on what it has promised to do. How it proceeds will have important repercussions for China, for the WTO and for the world economy. <center><a href="may00/alexandr.pdf" style="text-decoration: none">download article (PDF)</a> | <a href="#Index" style="text-decoration: none">return to index</a></center><hr> </td> </tr> </table> </body> </html>