title: The costs of constraint and prospects for health care reform in Canada.
abstract: The sharp decline and equally sharp recovery in public health care spending in the 1990s in Canada set the stage for a broad consideration of reform options but also established hurdles to be overcome in taking action. By moving health care to the center of the federal-provincial agenda, reconfiguring the internal politics of medical and hospital groups, and heightening a public sense of the need for improvement, the legacy of the 1990s prepared the ground for reforms that would "modernize" the Canadian model. But it also yielded a degree of federal-provincial rancor and provider demands for "catch-up," which complicated the process of achieving major change.
authors.affiliation: University of Toronto.
authors.forename: Carolyn Hughes
authors.initials: CH
authors.lastname: Tuohy
mesh_terms: D002170:Canada; D017046:Cost Savings / Q000706:statistics & numerical data; D017047:Cost Sharing; D005380:Financing, Government / Q000706:statistics & numerical data / Q000639:trends*; D018166:Health Care Reform / Q000331:legislation & jurisprudence*; D005102:Health Expenditures / Q000706:statistics & numerical data / Q000639:trends; D009313:National Health Programs / Q000191:economics* / Q000331:legislation & jurisprudence*; D011050:Policy Making; D011057:Politics; D011320:Primary Health Care; D017149:Private Sector; D017150:Public Sector; D012941:Social Responsibility; D019472:Universal Health Insurance / Q000331:legislation & jurisprudence*