Lessons For Canada Research Articles

Better Value for Money in Healthcare: European Lessons for Canada

Modern health systems, like Canada’s, face similar pressures. Populations are aging, government revenues are dwindling, and the scope for new services is increasing as new technologies develop. However, each country is responding to these pressures in unique ways. Arguably, Canadians pay too much attention to the United States health model – which is expensive and has a large uninsured population – making it a distraction for provincial policymakers. This Commentary instead focuses on the United Kingdom’s and the Netherlands’ healthcare systems. Those systems have undergone a period of reform to attain greater value for money and they adhere to equity principles similar to those underlying the Canadian system. A serious look at how these European countries align incentives within their systems to encourage better performance would be beneficial to health policy development in Canada.

Assessment of International Economic Policy Models and Measures: Lessons for Canada

We consider a typology of four social and economic policy models each pertaining to different groups of countries. These four policy systems namely the Nordic model, the Anglo-Saxon model, the Continental model, and the Mediterranean model, are described individually and in terms of selected public policies. In particular, we review the Swedish economic experience in promoting flexible labour markets and reforming its education sector, the French regulatory reforms in telecommunications and health care sectors, the competitive compulsory tendering and best value reforms in the United Kingdom, and the recent economic growth led by trade in Chile. Finally, we draw important lessons for reforms in Canada.

Learning Lessons from the National Health Service

The Canadian College of Health Service Executives has recently formalized a learning partnership with the UK's Institute of Healthcare Management. The development of such a partnership offers Canadian healthcare leaders an opportunity to learn from the UK's decade long multibillion pound effort to improve its healthcare system using a multipronged approach. This article provides an initial insight into the UK system starting with some of the high-level cultural differences between the UK and Canada. It is important to be aware of these differences as an appreciation of the context of the UK system can assist Canadian leaders in adapting the positive aspects to our system. The article describes some of the high-level cultural differences and then focuses on 3 specific areas that hold salient lessons for Canada: (1) the evolution of the primary care system, (2) the collection of structured and comparable consumer/patient feedback, and (3) a focus on quality (or clinical governance).

Cuba's system of maternal health and early childhood development: lessons for Canada

A healthy, nurturing and stimulating environment during a child's early years can make a difference in his or her later life.[1][1] Early childhood development is one of the determinants of health being studied by the Canadian Senate Subcommittee on Population Health to identify approaches to reduce

The Integration of Occupational Pension Policies: Lessons for Canada

Is the integration of occupational pension policies across the Canadian provinces feasible? In this paper, we assess the proposal for harmonization made by the Canadian Association of Pension Supervisory Authorities (CAPSA) by comparing it to the European Union's successful integration of member states’ pension policies. We argue that CAPSA's initiative failed both because regulatory diversity was defined as a fundamental problem and because the regulations that serve social policy goals were not protected from integration. We suggest that occupational pension integration in Canada would be feasible if provincial governments largely excluded rules on benefits and relied primarily on the mutual recognition of diverse rules.

The Integration of Occupational Pension Policies: Lessons for Canada

Is the integration of occupational pension policies across the Canadian provinces feasible? In this paper, we assess the proposal for harmonization made by the Canadian Association of Pension Supervisory Authorities (CAPSA) by comparing it to the European Union's successful integration of member states’ pension policies. We argue that CAPSA's initiative failed both because regulatory diversity was defined as a fundamental problem and because the regulations that serve social policy goals were not protected from integration. We suggest that occupational pension integration in Canada would be feasible if provincial governments largely excluded rules on benefits and relied primarily on the mutual recognition of diverse rules.

Consequences of Electoral Reform: Lessons for Canada

An informed policy debate about electoral reform in Canada must acknowledge the likely impact of any potential new system. Recent attention at the provincial level and from the Law Commission to a mixed electoral system warrants an examination of how such a system might alter Canadian politics. Although advocates of reform argue that proportional representation will increase proportionality, help smaller parties, increase the number of female representatives, increase turnout and improve attitudes toward politics, there is inconsistent evidence that a change in the electoral system alone would produce such changes. Although a mixed system would likely increase the proportionality of results, and would help smaller parties gain representation in any legislature, it may bring some unexpected findings as well. The following article identifies the claims of advocates we might expect to be true and those about which we should be more cautious.

Apprenticeship Training in European Countries. The Lessons for Canada

This paper investigates environmental conditions conducive to apprenticeship training; examines various government reactions in this field; discusses the problems and deficiencies of apprenticeship training in Canada, and analyzes the usefulness of European labour market measures to be employed in this country.

Parallel Private Health Insurance in Australia: A Cautionary Tale and Lessons for Canada

Canada’s restrictions on the role of private health insurance for publicly insured physician and hospital services are unique among countries with universal, publicly funded health care systems. Pressure is mounting in Canada, however, to loosen these restrictions and create a parallel system of private finance. Advocates argue that creation of a parallel system of private finance will ensure the sustainability of the public system (by reducing public cost pressures), improve access to the public system (e.g., by reducing wait times), and improve quality in the public system (through competition). Opponents of parallel private finance argue that it will create “two-tiered” medicine, increase costs, compromise equity and reduce quality and access to publicly financed health care as those with the financial means (and often the strongest voice) exit to private insurance. Australia provides a particularly promising case study for Canada regarding the dynamics of parallel systems of public and private finance. This paper examines Australia's experience with parallel finance for inpatient hospital services to provide insight regarding: (a) the effectiveness of a parallel system of private finance in reducing costs and wait times in the public system; (b) risk selection between the parallel public and private insurance sectors; (c) the financial redistribution associated with the introduction and maintenance of a parallel system of finance; and (d) the dynamics of the broader political economy associated with parallel systems of finance. Australia's experience provides a number of lessons for Canada, including: (1) the potential for cost savings through introduction or expansion of a parallel private sector is very limited; (2) the introduction or expansion of a parallel private finance is unlikely to reduce wait times in the publicly financed system; (3) there is no simple way to regulate private insurers to pursue public objectives; (4) it is impossible to create an independent, isolated parallel system of private finance is false -- interactions between the public and private insurance sectors are complex and unavoidable; (5) quality plays a key role in driving the dynamics between the public and privately financed sectors; and (6) it is essential to articulate clear policy objectives for health care financing and to design public and private roles consistent with these objectives. Our overall conclusion is that the Australian experience provides a cautionary tale regarding the risks, costs and benefits of a parallel private system of health care finance.

The Edinburgh Festival and Fringe: Lessons for Canada?

A visit to the last ten days of the formidable Edinburgh International Festival and its famous Fringe – the ur-festivals for English language international festivals and fringes in Canada as elsewhere – provides the opportunity for some comparative musings on the cultural role played by such events in both Scotland and Canada. In a consciously provocative opinion piece in the Spring 1992 issue of Theatre Forum, Ritsaert ten Cate asked, “Festivals: Who Needs ‘Em?” In attempting to answer the question – “travel agents, who can offer package deals” is the closest he seems to get, quoting a “deadly serious” American student (87) – ten Cate raises some issues that remain crucial to any discussion of the cultural work performed by international festivals at the turn of the millennium. He focuses on a familiar, mutually reinforcing binary that seems to set artists/producers against the economic and other interests of governments, funders and “the part of society that provides cash backing for a festival (an overlapping, but essentially different part of society from that which makes up our audiences)” (87). It’s “‘us’ against ‘them,” he says (86). But his essay also touches on less familiar, more useful territory, including “the presentation of our registered cultural trademarks” (87) and “a move toward multiculturalism which seems inspired more by pragmatic reasoning, political opportunism, and the availability of funding than … by any involvement of the heart” (87). Noting ruefully that “we have witnessed just how successfully the arts can be incorporated as a useful aspect of consumer society,” he argues, against his own “better” instincts, that festival organizers “must consider what their own function is within the larger context of a melange of art and society and the world …” (86, emphasis in original).

Equalization: Its Contributions to Canada's Economic and Fiscal Progress

The fiscal equalization program is one of the cornerstones of Canadian fiscal federalism. The proceedings of a conference held in May 1997, this collection of papers and commentaries focuses on a range of issues and implications surrounding the evolution, structure, and reform of the equalization program. Papers include a survey of the principles against which the equalization program ought to be evaluated, an assessment of the functioning of the program as presently structured, a consideration of the political climate within which the commitment to fiscal equalization will find its definition, a response to the proposition that there is too much equalization in Canada through an examination of the degree of interprovincial revenue redistribution resulting from the program, and a comparison with the German, Australian, and United States federations in search of lessons for Canada. Contributors include Robin Boadway (Queen's), Doug Clark (formerly of the Department of Finance), David Milne (UPEI), Paul Hobson (Acadia), and Sam Wilson (Alberta). Commentaries are provided by Tom Courchene (Queen's), Francois Vaillancourt (Montreal), and Wade Locke (Memorial)."

The Quebec Midwifery Experiment: Lessons for Canada

The Quebec Midwifery Experiment: Lessons for Canada

The Quebec midwifery experiment: Lessons for Canada (Editorial)

The Quebec midwifery experiment: Lessons for Canada (Editorial)

Hospitals in the UK health system: lessons for Canada.

Hospitals in the UK health system: lessons for Canada.

Judicial review and environmental policy: lessons for Canada from the United States

Abstract: United States' experience with judicial review under NEPA suggests that it would be inappropriate to enhance the role of the courts in developing and enforcing environmental policy in Canada. Early judicial review did help ensure that the EIS requirements under NEPA were taken seriously. In addition, early environmental litigation may have helped mobilize public environmental concerns. However, these effects were limited, at best, and are now minimal. On the other hand, the emphasis on judicial review under NEPA has significantly harmed the American environmental policy process, making it formal, defensive and confrontational.Specifically, judicial review of NEPA has created five main problems: it emphasizes superficial procedural compliance at the expense of substantive policy improvements; important value questions are obscured by the emphasis on analytical process; the availability of judicial review focused advocacy resources on the courts, and away from potentially more effective political and social action; by enhancing public responsiveness, judicial review distorts priorities; and judicial review fosters an adversarial relationship that inhibits institutional learning and collaborative policy development, undermining the critical dialogue by which the environmental assessment process is assumed to improve policy.The courts must continue to play some role. They provide the best guarantee of process. The lesson from NEPA, however, is that the courts should only be relied upon as a backstop. Instead, efforts should focus on creating incentives within the environmental “policy community” to maximize the potential for policy learning. This will require the continued development of mechanisms that facilitate collaborative policy development, rather than enhancing the role of judicial review and other formal mechanisms that encourage parties to focus on specific issues from fixed perspectives.Sommaire: L'expérience américaine de la révision judiciaire en vertu de la NEPA suggère qu'il ne serait pas souhaitable de renfurcer le rôle des tribunaux dans l'élaboration et l'application des politiques environnementales au Canada. Les premières décisions des tribunaux ont aidéà s'assurer que les exigences de rapports EIS en vertu de la NEPA étaient prises au sérieux. Elles ont peut‐être aussi aidéà mobiliser les préoccupations du public face à l'environnement. Cependant, ces effets ont été au mieux limités, et ils sont maintenant minimes. D'autre part, l'accent mis sur Id révision judiciaire en vertu de la NEPA a nui sérieusement au processus américain de définition des politiques environnementales, en le rendant formel, défensif et conflictuel.Plus précisément, la révision judiciaire dans le cadre de la NEPA Crée cinq problèmes principaux:* elle met l'accent sur la conformité purement procédurale aux dépens de l'amélioration fondamentale des politiques;* des questions importantes sur les valeurs sont éclipsées par l'emphase mise sur le procédé analytique;* la disponibilité d'une révision judiciaire a concentré sur les tribunaux les ressources des groupes de revendication, les écartant des actions politiques et sociales qui risquent d'être plus efficaces;* en augmentant la sensibilité du public, la révision judiciaire Crée une distorsion dans les priorités; et* la révision judiciaire déclenche des rapports conflictuels qui freinent l'apprentissage institutionnel et l'élaboration de politiques de collaboration, affaiblissant par là le dialogue critique par lequel le processus EIS est censé améliorer les politiques.Les tribunaux doivent continuer à jouer un certain rôle. Ils offrent la meilleure garantie procédurale. Toutefois, d'après l'expérience de la NEPA, on ne devrait les invoquer qu'en dernier lieu. II faudrait plutôt concentrer les efforts sur la création de moyens visant à motiver la “ collectivité active “ dans les politiques environnementales afin de maximiser le potentiel d'apprentissage dans ce cadre. Pour cela, il faudra une mise au point continue de mécanismes facilitant l'élaboration de politiques collaboratives, plutôt qu'une expansion du rôle de la révision judiciaire et des autres mécanismes formels qui encouragent les parties en cause à se pencher sur des questions précises à partir de rôles rigidement définis.

Health Care and Aging Populations: Canada and the United States

Health Care Policy in the United States: Lessons for Canada At first blush, the suggestion that the American experience in health care policy may contain some helpful lessons for Canada may seem surprising. For one thing, there is a large body of opinion in the United States (and also in Canada) which holds that the adoption of a system closely modelled on the Canadian one represents a promising type of reform for the United States, as that country tries to repair some of the worst deficiencies in its system of health insurance and health services provision. By the same token, most Canadians consider their health care system as vastly superior to the American one, and would argue that any change inspired by the American example is bound to be a change for the worse.

Evolution of U.S. Soil Conservation Policies Since World War II: Lessons for Canada

Evolution of U.S. Soil Conservation Policies Since World War II: Lessons for Canada

Management training for women: International experiences and lessons for Canada

In Canada, there is growing recognition that women play an increasingly important role in the working world. Management training programs for women have been considered as a route to prepare women to be more effective managers. This paper highlights some of the major issues and concerns being discussed outside Canada by those engaged in management education and training for women — objectives and content of programs, nature of participants, training methods, choice of trainers, organization and evaluation of programs. References are made to a few international programs to illustrate how some of these concerns have been addressed. Implications for training programs in Canada, from both practical as well as research points of view, are discussed.

The Swedish approach to investing public pension funds: Some lessons for Canada ?

Abstract. Unlike the Canada Pension Plan, which is financed largely on a pay‐as‐you‐go basis, Sweden's national earnings‐related pension scheme is designed to accumulate a large reserve fund. The degree to which the scheme is funded and the consequent size of its reserve fund means that the Swedish system presents public policy‐makers in Canada with a unique opportunity to observe some of the methods, consequences and problems that arise as a result of funding a large earnings‐related public pension plan.Of particular interest is the administrative structure of the fund and its investment activities. The National Pension Insurance (ap) Fund, as it is called, has aroused considerable attention abroad because it plays a major role in Sweden's capital market, and is frequently cited as an example of how a partially funded public pension plan might invest its assets in the private sector of the economy. This paper describes the role of the AP Fund and its autonomous sub‐funds. Particular attention is paid to the Fourth Fund which invests in equity shares.Somrnaire: Contralrement au Régime de pensions du Canada, qui est financé au fur et à mesure, le régime national suédois, qui offre une retraite proportionnelle aux revenus, a été conçu pour permettre l'accumulation d'un fonds de réserve important. Le degré d'approvisionnement du fonds, et par conséquent son importance, offrent aux organismes canadiens chargés d'établir les programmes une occasion unique d'observer quelques méthodes, quelques résultats et quelques problèmes qui découlent de l'approvisionnement d'un pareil régime.La structure administrative du fonds et ses politiques d'investissement sont particulièrement intéressantes. Le Fonds national d'assurance‐retraite (ap), comme on l'appelle, a suscité beaucoup & d'attention à l'étranger, car il joue un rôle important sur le marché suédois des capitaux. Bien souvent, c'est l'exemple dont on se sert pour décrire comment un régime de retraite public, partiellement approvisionné, pourrait investir ses avoirs dans le secteur privé de l'économie.