Jeremiah Hurley () (Department of Economics, Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, McMaster University) Diana Pasic John Lavis (Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, McMaster University) Cameron Mustard (Institute of Work and Health, Toronto, Department of Public Health Sciences, University of Toronto) Tony Culyer (Institute of Work and Health, Toronto, Department of Economics and Related Studies, University of York, UK, Cancer Care Ontario, Department of Health Policy, Management, and Evaluation, University of Toronto) William Gnam (Institute of Work and Health, Department of Pschiatry, University of Toronto)
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This paper uses a case study approach to document and analyze the interactions that arise between two health care payers in Canada: the provincial public health care insurance plans and the provincial Workers Compensation Boards. Through a documentary review and semistructured key-respondent interviews, the study identified a set of policy events and decisions undertaken by each payer that had consequences for the other. These events, which included changes to governance, funding, and service delivery within each system, generated interactions transmitted through the political environment, the institutional environment , the economic environment (primarily through competition for the same resources) and cross-system learning. The two payers currently lack a formalized process by which to consider such spillover effects and to coordinate policy between them. These interactions and their associated consequences for both payers raise important policy challenges and provide insight into the dynamics of a parallel system of health care finance more generally.
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Length: 23 pages Date of creation: 2007 Date of revision: Handle: RePEc:hpa:wpaper:0703
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