Canadians are justifiably proud of Medicare. All (but one) of the major industrialized countries have established universal public payment systems for health care, and most are similarly proud, or at least highly supportive, of them. National systems differ in important details but in broad...

In this paper we review and extend an earlier, in-depth analysis of the effects of users ccharges. The present paper assesses whether experience and published literature in the years since 1979 alter any of the (largely negative) conclusions of the earlier study concerning the ability of direct...

The year 1981 appears, in retrospect, to have been something of a turning point in the evolution of the Canadian health care system. It was not obvious at the time -- the year did not, 1961 or 1971, mark the completion of a clearly defined stage of public coverage or, like 1978, a major shift in...

In this paper we examine some of the most frequently heard arguments for user charges and look at what evidence there is for claims and counter-claims that are often made.

Our system of universal public insurance for health care is by a considerable margin Canada's must successful and popular public program. We think of it, not just as an administrative mechanism for paying medical bills, but as an important symbol of community, a concrete representation of mutual...

All proponents of health reform seek to improve the health of the population served. Or so they say. Yet the policies and strategies offered are extraordinarily diverse, and to a considerable degree inconsistent or in direct conflict with each other.

In this paper we propose a conplexe framework to present a wide range of relationships among the determinants of health.

Since the late 1960s, concerns over the escalating costs of health care have been expressed with increasing vigor on both sides of the Canada-United States border. This is in sharp contrast with the previous 20 years, during which the principal policy concern was to "meet needs" by finding ways...

Governments and private insurers in North America are becoming increasingly involved in providing coverage for prescription drugs. Although the catastrophic coverage provision under Medicare has been withdrawn, the inclusion of insurance for outpatient drugs in that legislation reflects the...

In general, one may infer with some confidence that any cost containment policy conmdemned as ineffective by those whose incomes it is intended to contain, but described as effective by those who are responsible for paying the bills, is almost certainly "working" -- at least to contain costs.