Bending the cost curve in health care : [Canada's provinces in international perspective

Through Canadian and international perspectives, __Bending the Cost Curve in Health Care__ explores the management of growing health costs in an extraordinarily complex arena.

Through Canadian and international perspectives, Bending the Cost Curve in Health Care explores the management of growing health costs in an extraordinarily complex arena. The book moves beyond previous debates, agreeing that while efficiencies and better value for money may yet be found, more fundamental reforms to the management and delivery of health services are essential prerequisites to bending the cost curve in the long run. While there is considerable controversy over direction and details of change, there also remains the challenge of getting agreement on the values or principles that would guide the reshaping of the policies, the structures, and the regulatory environment of health care in Canada.

Leading experts from around the world representing a range of disciplines and professional backgrounds come together to organize and define the problems faced by policy-makers. Case studies from the United States, the United Kingdom, Australia, the Nordic countries, and industrialized Asian countries such as Taiwan offer useful reform experiences for provincial governments in Canada. Finally, common Canadian cost factors, such as pharmaceuticals and technology, and paying the health workforce, are explored.

This book is the first volume in The Johnson-Shoyama Series on Public Policy, published by the University of Toronto Press in association with the Johnson-Shoyama Graduate School of Public Policy, an interdisciplinary centre for research, teaching, and executive training with campuses at the Universities of Regina and Saskatchewan.

Contents 5 List of Illustrations 7 Introduction and Overview 15 Part I: General Considerations on Bending the Cost Curve 39 1 Why We Should Bend the Cost Curve and How We Could Do It 39 2 Financial Incentives and Pay-for-Performance 73 3 Tax Burdens and Aging 103 Part II: Pan-Canadian Cost Drivers and Political Considerations 125 4 Common Provincial Determinants and Cost Drivers 125 5 Pharmaceuticals 151 6 Paying the Health Workforce 177 7 Three Federal Approaches to Cost Containment in Health Care 207 8 The Federal Role in Health Care 231 Part III: Provincial Experiences in Canada 255 9 Ontario: Changing Policies, Changing Categories 255 10 Québec: Sustainability—Perception and Reality 277 11 British Columbia: Cost Control in the Country of the Red Queen 309 12 Alberta: Health Spending in the Land of Plenty 335 13 Saskatchewan and Manitoba: Managing Down 365 14 Atlantic Canada: The Impact of Aging on the Cost Curve 383 Part IV: What Can Canada Learn from the International Evidence? 405 15 The United States 405 16 Australia 419 17 England 449 18 Nordic Countries 465 19 Taiwan and Other Advanced Asian Economies 483 Index 501