Bending the Cost Curve in Health Care: Canada's Provinces in International Perspective

Bending the Cost Curve in Health Care: Canada's Provinces in International Perspective

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Edited by Gregory P. Marchildon and Livio Di Matteo
The Johnson-Shoyama Series on Public Policy
University of Toronto Press, Higher Education Division © 2014
World Rights
479 Pages
ISBN 9781442609754
Published Dec 2014
ISBN 9781442609761
Published Dec 2014
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ISBN 9781442609785
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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.

Gregory P. Marchildon is Professor and Ontario Research Chair in Health Policy and System Design at the Institute of Health Policy, Management and Evaluation, University of Toronto.

Livio Di Matteo is Professor of Economics at Lakehead University. His articles have appeared in many academic international health journals, including the Journal of Health Economics, Health Policy, European Journal of Health Economics, and Health Economics, Policy and Law.
List of Illustrations

Introduction and Overview

Part I: General Considerations on Bending the Cost Curve
1. Why We Should Bend the Cost Curve and How We Could Do It
Uwe Reinhardt
2. Financial Incentives and Pay-for-Performance
Jeremiah Hurley and Jinhu Li
3. Tax Burdens and Aging
John Richards and Colin Busby

Part II: Pan-Canadian Cost Drivers and Political Considerations
4. Common Provincial Determinants and Cost Drivers
Livio Di Matteo and J. C. Herb Emery
5. Pharmaceuticals
Steven G. Morgan, Jamie R. Daw, and Paige A. Thomson
6. Paying the Health Workforce
Phil Leonard and Arthur Sweetman
7. Three Federal Approaches to Cost Containment in Health Care
Katherine Fierlbeck
8. The Federal Role in Health Care
Pierre-Gerlier Forest

Part III: Provincial Experiences in Canada
9. Ontario: Changing Policies, Changing Categories
Raisa Deber and Sara Allin
10. Québec: Sustainability—Perception and Reality
François Béland and Claude Galand
11. British Columbia: Cost Control in the Country of the Red Queen
Kimberlyn M. McGrail and Robert G. Evans
12. Alberta: Health Spending in the Land of Plenty
Stephen Duckett
13. Saskatchewan and Manitoba: Managing Down
Gregory P. Marchildon
14. Atlantic Canada: The Impact of Aging on the Cost Curve
Joe Ruggeri

Part IV: What Can Canada Learn from the International Evidence?
15. The United States
Gerard Anderson
16. Australia
Stephen Duckett
17. England
Alan Maynard
18. Nordic Countries
Jon Magnussen
19. Taiwan and Other Advanced Asian Economies
Tsung-Mei Cheng