[Recent health services reform in Quebec Province, Canada: on the frontier of preserving a public system].

https://arctichealth.org/en/permalink/ahliterature196003
Source
Cad Saude Publica. 2000 Oct-Dec;16(4):963-71
Publication Type
Article
Author
E M Conill
Author Affiliation
Departmento de Saúde Púbica, Núcleo de Apoio à Municipalização e Implementação do SUS em Santa Catarina, Universidade Federal de Santa Catarina, Florianópolis, SC 88040-970, Brasil. eleonor@repensul.ufsc.br
Source
Cad Saude Publica. 2000 Oct-Dec;16(4):963-71
Language
Portuguese
Publication Type
Article
Keywords
Canada
Health Care Reform - economics - organization & administration
Humans
National health programs - organization & administration
Organizational Case Studies
Organizational Innovation
Politics
Privatization
Quebec
Universal Coverage
Abstract
This paper analyzes recent changes in the Canadian health system through a case study of Quebec. As the last Province to adopt federal principles of universal coverage, comprehensiveness, and public management, its reform, conducted in 1971, met these objectives by means of key innovations. In the 1980s and early 90s, a process of health services evaluation in this Province and in Canada as a whole launched a period of extensive changes. The relevant measures are described herein: decentralization and regional management, "clinical shift", selective reduction in the supply of services, and new mechanisms for resource allocation and social control. There is a tendency towards an environment of public competition, but the approach that was adopted for regulation does not correspond to the main models from central countries. Within a scenario of budget constraints, technocratically-defined measures allowed for the settlement of benefits, preserving the system's main guidelines. This evidence is one of the main contributions of comparative analysis to health system reform in peripheral countries. The study identifies the relationships between these measures and a worldwide trend towards cost control and macroeconomic adjustment policies, discussing the relevant implications for health services.
PubMed ID
11175520 View in PubMed
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