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Is Canada Odd? A Comparison of European and Canadian Approaches to Choice and Regulation of the Public/Private Divide in Health Care

Health Economics, Policy and Law, 2010

26 Pages Posted: 27 Feb 2009  

Colleen M. Flood

University of Ottawa - Faculty of Law

Amanda Haugan

University of Toronto

Date Written: February 26, 2009

Abstract

Choice is often touted as a means for change within health care systems. Yet 'choice', in this context, takes at least three distinct forms: choice between providers within a publicly funded health care system; choice between competing insurers within a universal plan; and, lastly, choice as between privately financed health care and universal public coverage. In Canada, it is this last form of choice that is under active debate, particularly in light of the Supreme Court of Canada's decision in Chaoulli which found a regulation banning private health insurance for medically necessary care to be unconstitutional. The argument is frequently made that Canada is an outlier in having regulation that effectively precludes this kind of choice. This paper tests that argument by exploring regulation of choice of privately financed health care in several European countries - the Netherlands, Germany, Sweden, England and France. We highlight commonalities as well as differences, showing the extent to which these countries employ regulation to fetter growth of a large privately-financed sector. The paper's thesis is that Canada, in employing more intrusive forms of regulation, is not an outlier per se but at one end of a regulatory spectrum.

Suggested Citation

Flood, Colleen M. and Haugan, Amanda, Is Canada Odd? A Comparison of European and Canadian Approaches to Choice and Regulation of the Public/Private Divide in Health Care (February 26, 2009). Health Economics, Policy and Law, 2010. Available at SSRN: https://ssrn.com/abstract=1350012

Colleen M. Flood (Contact Author)

University of Ottawa - Faculty of Law ( email )

57 Louis Pasteur Street
Ottawa, K1N 6N5
Canada
416-697-4594 (Phone)

Amanda Haugan

University of Toronto ( email )

Department of Statistical Sciences
Toronto, Ontario M5S 3G8
Canada

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