"Medical effectiveness" in Canadian and U.S. health policy: the comparative politics of inferential ambiguity.
OBJECTIVE
To compare Canadian and U.S. policymaking to determine how different health care systems may use health services research differently in responding to the common problem of ineffective medical care. DATA SOURCES/STUDY DESIGN/DATA COLLECTION: Not applicable.


RESULTS
The United States and Canada are making surprisingly divergent responses to the problem of medical ineffectiveness: reinforcement of the solidarity principle and deprivatization in Canada, and reinforcement of market competition and privatization in the United States. In doing so, Canadian policymakers overstate the societal applicability and U.S. policymakers the individual applicability of outcomes research findings.


CONCLUSIONS
Probabilistic findings of medical effectiveness are fundamentally ambiguous as they relate to action. They therefore invite divergent policy responses from different policy regimes. Health services researchers must not imagine that research findings are sufficient to determine the course of health policy.
Tanenbaum
S J
SJ
Ohio State University College of Medicine, Columbus 43210-1234, USA.
D001291:Attitude of Health Personnel; D002170:Canada; D003695:Delivery of Health Care / Q000458:organization & administration*; D004465:Economic Competition; D006291:Health Policy; D006302:Health Services Research; D006801:Humans; D017060:Patient Satisfaction; D010820:Physicians / Q000523:psychology; D011057:Politics; D011332:Privatization; D016896:Treatment Outcome; D014481:United States