Examining private and public provision in canadaa's provincial health care systems: Comparing Ontario and Quebec

Howard A. Palley, Marie Pascale Pomey, Pierre Gerlier Forest

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Globally, the mix of private- and public-sector involvement in health care delivery is a focus of political concern. This concern in Canada takes place within the parameters of the federal Canada Health Act. Private for-profit activities in the health care sector in Canadian provinces have moderately shrunk the definition of 'necessary medical and hospital servicesa' that must be provided by the public administration system under the federal Canada Health Act. In this article, we argue that the development of new technologies, pharmaceutical innovations, competing (non-health) demands on the federal dollar, and an aging population together create an environment where pressures for economic and political sustainability have led to some erosion of necessary health services in the provinces. Such pressures have, in turn, led to the growth of private commercial-sector health services. Within Canadaa's federal system, provincial negotiation of the role of commercial health care organizations has developed in different ways in Ontario and Quebec. Such subnational developments are a significant focus for comparative health policy analysis.

Original languageEnglish (US)
Pages (from-to)79-94
Number of pages16
JournalInternational Political Science Review
Issue number1
StatePublished - Jan 2011


  • Canada
  • Federal government
  • Health care systems
  • Long-term care
  • Medical services
  • Provinces

ASJC Scopus subject areas

  • Sociology and Political Science
  • Political Science and International Relations


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