Bilateral Federalism, Value-Based Healthcare and the Future of Canadian Intergovernmental Diplomacy on Health.

The COVID-19 pandemic has laid bare some profound challenges facing the preservation of Canada's single-payer, publicly administered healthcare system. At the same time, it may have presented an opportunity to take bold action on system reform. Part of that opportunity may lie in linking recent developments in intergovernmental diplomacy (termed bilateral federalism) with the growing emphasis on value-based healthcare initiatives coming out of some of the provinces.

Equity Analysis of Repeated Cross-Sectional Survey Data on Mental Health Outcomes in Saskatchewan, Canada during COVID-19 Pandemic.

This paper aims to understand the impact of COVID-19 on three mental health outcomes-anxiety, depression, and mental health service use. Specifically, whether the associations between social and economic variables and these outcomes are exacerbated or buffered among equity-seeking groups in Saskatchewan. We analyzed secondary datasets of Saskatchewan adults from population-based national surveys conducted by Mental Health Research Canada (MHRC) on three occasions: cycle 2 (August 2020), cycle 5 (February 2021), and cycle 7 (June 2021).

Competing challenges for immigrant seniors: Social isolation and the pandemic.

The pandemic has exposed and amplified complex and complicated health and societal challenges while offering immense opportunities to transform societies to improve health for all. Social isolation is a challenging and persistent issue experienced by many older adults, especially among immigrant and refugee seniors. Unique risk factors such as racism, discrimination, language barriers, weak social networks, and separation from friends and family predispose immigrant and refugee seniors to a higher risk of social isolation.

From Autonomous Gatekeepers to System Stewards: Can the Alberta Agreement Change the Role of Physicians in Canadian Medicare?

Marchildon and Sherar's (2018) "Doctors and Canadian Medicare" presents a specific dilemma for healthcare reform: the ability of physicians to negotiate ever-increasing incomes without reference to the consequences to healthcare costs or provincial budgeting. This commentary situates that discussion in the broader debate of the challenges to healthcare reform as exemplified by studies such as Paradigm Freeze (Lazar et al. 2013) and the ability of provincial medical associations to act as both system insiders (gatekeepers) and outsiders (with no responsibility for system finances).

No Place Like Home: A Systematic Review of Home Care for Older Adults in Canada.

ABSTRACTGiven Canada's aging population, the demand for home care is expected to increase significantly. To date, little is known about home care for older adults in Canada such as characteristics of home care recipients, gaps in services, or interventions designed to support home care client needs. Consequently, we conducted a systematic review of seven electronic databases for the years 2000-2016 to examine the current knowledge of home care services for Canada's older adults.

Healthcare, Intergovernmentalism and Population Health: The Challenge of Reform in an Era of Disengagement.

The model proposed by Gardner, Fierlbeck and Levy offers an innovative and compelling framework for moving past the dysfunction of the current intergovernmental relationship in health. It provides a viable role for the federal government and a means to shift our attention on improving health outcomes relative to past provincial performance. At the same time there are important questions about how both federal leadership and population health is understood and justified within the model.

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.