Do provincial drug benefit initiatives create an effective policy lab? The evidence from Canada.
Although the costs of doctors' visits and hospital stays in Canada are covered by national public health insurance, the cost of outpatient prescription drugs is not. To solve problems of access, Canadian provinces have introduced provincial prescription drug benefit programs. This study analyzes the prescription drug policymaking process in five Canadian provinces between 1992 and 2004 with a view to (1) determining the federal government's role in the area of prescription drugs; (2) describing the policymaking process; (3) identifying factors in each province's choice of a policy; (4) identifying patterns in those factors across the five provinces; and (5) assessing the federal government's influence on the policies chosen. Analysis shows that despite significant differences in policy choices, the ideological motivations of the provinces were unexpectedly similar. The findings also highlight the importance of institutional factors, for example, in provinces' decision to compete rather than to collaborate. We conclude that, to date, Canada's federalism laboratory has only partly benefited the Canadian public. Cost pressures may, however, eventually overcome barriers to cooperation between the provincial and the federal governments, enabling them to capitalize on Canada's federal structure to improve the accessibility and affordability of drugs.
University of Montreal.
Marie-Pascale
MP
Pomey
Steve
S
Morgan
John
J
Church
Pierre-Gerlier
PG
Forest
John N
JN
Lavis
Tom
T
McIntosh
Neale
N
Smith
Jennifer
J
Petrela
Elisabeth
E
Martin
Sarah
S
Dobson
D002170:Canada; D035082:Federal Government; D006291:Health Policy; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D009313:National Health Programs; D011050:Policy Making; D055553:Prescription Drugs / Q000191:economics; D013219:State Government
D055553:Prescription Drugs