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Exposing Privatization

Exposing Privatization: Women and Health Care Reform in Canada

Pat Armstrong
Carol Amaratunga
Jocelyne Bernier
Karen Grant
Ann Pederson
Kay Willson
Copyright Date: 2001
Pages: 310
  • Book Info
    Exposing Privatization
    Book Description:

    This book begins with the international context for health care reform and then moves from coast to coast, setting out what is known about the reforms in health care privatization that are underway and about their impact on women.

    eISBN: 978-1-4426-0255-7
    Subjects: Health Sciences, Political Science, Sociology

Table of Contents

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  1. Front Matter
    (pp. 1-4)
  2. Table of Contents
    (pp. 5-7)
  3. Introduction
    (pp. 8-10)
    Pat Armstrong, Carol Amaratunga, Jocelyne Bernier, Karen Grant, Ann Pederson and Kay Willson

    What is happening in Canadian health care reform? What does it mean for women? Given the government, academic and media concern with health care, you would think there would be an easily accessible answer to the first question. And given that women make up 80 per cent of health care providers, paid and unpaid, and a majority of patients, you would expect the question of the impact on women to be at the top of the agenda. But you would be wrong.

    This is the conclusion we came to after investigating both issues. The we is the National Coordinating Group...

  4. The Context for Health Care Reform in Canada
    (pp. 11-48)
    Pat Armstrong and Hugh Armstrong

    Health care reform has seldom been a strictly local matter. Canada has developed some unique reform strategies and adapted others to suit its particular circumstances – and Canada is not without influence abroad, particularly in the areas of health promotion (Pederson, O’Neill and Rootman 1994) and gender-based analysis. But foreign influences and external pressures have seldom been absent. Health care reform, then, has to be understood within an international context.

    This article seeks to contextualize current reforms, outlining some of the international and national pressures and influences that shape strategies to change health care in Canada. It then looks at...

  5. Health Restructuring and Privatization from Women’s Perspective in Newfoundland and Labrador
    (pp. 49-94)
    Ingrid Botting

    Since the early 1990s, Newfoundland and Labrador has experienced extensive reform and restructuring of its health care system. The cornerstone of the reform initiative was the regionalization of health care delivery and management, which has largely meant a transfer of direct responsibility for service provision and delivery from the state to the recently established regional Community Health and Institutional Boards. Another significant aspect of reform and restructuring has been the adoption of a population health approach, which implies a shift towards prevention through a focus on health determinants such as income, education, employment and gender. A population health model has...

  6. Health Reform, Privatization and Women in Nova Scotia
    (pp. 95-120)
    Barbara Clow

    Despite the important place of publicly funded health care in the Canadian psyche and despite the profound health and care implications of reform in the 1990s, analysis of provincial reform initiatives has been limited. Few researchers have examined the evolution of policy and planning, or the impact of privatization. Moreover, gender issues and gender analysis have been conspicuously absent in many policy and academic discussions, despite the fact that women represent the largest proportion of health care workers and consumers in this country. This analysis of health reform in Nova Scotia aims to improve our understanding of the reform process...

  7. What Price Have Women Paid for Health Care Reform? The Situation in Quebec
    (pp. 121-162)
    Jocelyne Bernier and Marlène Dallaire

    The health and social services system in Quebec has undergone major transformations since the early 1990s. This chapter examines the consequences that this reform has had on women, considering the differing roles that women and men play in society.¹ It also considers the effects that these measures have had on the status and health of women from differing socioeconomic environments.

    Some differences have already been well established in surveys of public health (Potvin and Frohlich 1998). More women than men report being in poor health or only fair health, and women report making more use of health care services, even...

  8. Women, Privatization and Health Care Reform: The Ontario Case
    (pp. 163-216)
    Pat Armstrong and Hugh Armstrong

    Privatization of public health care did not begin in 1995 when the Conservatives won a majority government in Ontario. The previous Liberal and New Democratic governments had already begun to de-list some services and promote the contracting out of others. However, the government of Mike Harris increased dramatically both the pace and the extent of change. Titling their programThe Common Sense Revolution, the Conservatives promised to “provide the people of Ontario withbetterforless, ” while guaranteeing ”full funding for health care,” “without touching a penny” of the money for health services. These promises were to be kept...

  9. Missing Links: The Effects of Health Care Privatization on Women in Manitoba and Saskatchewan
    (pp. 217-252)
    Kay Willson and Jennifer Howard

    Prairie women’s organizations played an important role in the historical development of a publicly funded and administered health care system in Canada. Saskatchewan is the birthplace of medicare. While former Saskatchewan Premier Tommy Douglas is often credited as one of the “fathers of medicare,” prairie women like Violet McNaughton, Sophia Dixon and Louise Lucas could well be called the “mothers of medicare.” Years before the introduction of medicare, organizations of rural women campaigned for a publicly funded, locally controlled system that would ensure medical assistance to all. They raised public awareness and built alliances that encouraged prairie farm organizations, the...

  10. The Differential Impact of Health Care Privatization on Women in Alberta
    (pp. 253-286)
    C. M. Scott, T. Horne and W.E. Thurston

    This chapter explores the extent to which health care privatization is taking place in Alberta, and considers the impact of health care privatization on women. While it does not attempt to provide a complete review of all policy related to health care privatization, it provides an overview of policies and initiatives that exemplify the Alberta government’s policy platform.

    Horne, Donner and Thurston (1999) reviewed tools for applying gender-based analysis within the health sector, developed a framework and applied it to policy documents in Manitoba and Saskatchewan. They recommended that both processes and policy or program content be assessed for gender...

  11. The Information Gap: The Impact of Health Care Reform on British Columbia Women
    (pp. 287-306)
    Colleen Fuller

    British Columbia was one of the first provinces in Canada to initiate major reforms in the health care system during the 1990s. Many of these reforms followed the recommendations of the Royal Commission on Health Care and Costs whose 1991 report,Closer to Home, attributed problems in the health care system to structural, administrative and funding practices. These practices, the report concluded, were responsible for growing disparities in health across the population and inequities in access to health services. The lack of an overall plan for health services delivery throughout the province and misplaced priorities in health spending also pointed...

  12. Conclusion
    (pp. 307-308)

    These reports from across the country expose the extensive privatization of health care in Canada and lead to several conclusions:

    1. All the provinces have moved to shift health care costs to individuals, to shift care delivery to for-profit concerns, to shift managerial practices to for-profit approaches, to shift care responsibility to households and care work to unpaid caregivers. Our definition of privatization is useful in revealing the multiple forms privatization is taking in Canada.

    2. Although there are similarities among provinces, there are also significant differences. The process is uneven across the country. Indeed, some provinces have reversed privatization in some...

  13. About the Authors
    (pp. 309-310)