Is Two-Tier Health Care the Future?

Canada is frequently portrayed as the odd-man out in significantly restricting private finance in public medicare. But constitutional challenges to laws protecting public medicare are underway. If private clinics and physician applicants succeed in having the courts strike down laws protecting public medicare then policy-makers will have a very short window of opportunity within which to respond with new laws and policies protecting Canadian medicare from extensive privatization.

Contributors to this volume are from law, economics, history, medicine, sociology, political science and public policy. Fusing these disciplines provides a full analysis of the issue of how best to regulate two-tier care.

Specific topics covered include the history of private finance in Canadian medicare; an analysis of historical and current Charter challenges to medicare; analyses of the regulation of two-tier care in Australia, Ireland and France and lessons for Canada; the economics of parallel private finance; the links between rising inequality and demand for private insurance; the ethics of queue-jumping; two-tier care in home care in Canada; self-regulation as a means of regulating two-tier care; the use of physician contracts to restrict two-tier care; and a synthesis of law and policy options for regulating two-tier care in Canada. Cross-cutting themes throughout these rich, multidisciplinary chapters are drawn out in the volume's introduction and conclusion to provide readers a robust understanding of what is at stake in the debate over whether two-tier health care is the future.