Parallel Lines do Intersect: Interactions between the Workers’ Compensation and Provincial Publicly Financed Health Care Systems in Canada

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.