Int J Health Serv
-
Comparative Study
Further refinements of Canadian/U.S. health cost containment measures.
Critics of the Canadian health care system have argued that the lower health care share of gross national product (GNP) in Canada relative to the United States is more likely to be associated with a relatively more rapid growth in GNP in Canada than with the ability of the Canadian single-payer system to contain costs. In this article the authors use both the level and the average annual growth rate of health care's share of GNP to provide an assessment of cost containment for the United States and Canada. They conclude that the suggestion that the success of the Canadian system has been an illusion created by its more rapid growth in GNP is not supported once the appropriate adjustments are made to the data.
-
Considerations of equity in the context of health care systems are often related closely to the presence or level of prices incurred by users of health care services. Some politicians and commentators have suggested that the removal of user charges under the Canadian health care system has led to equal access to care. But it is not clear that the equity principle inferred from these claims corresponds to the equity goals of current Canadian health policy. ⋯ They then consider other approaches to equity in health care in the context of the stated objectives of Canadian health policy and identify the implications of pursuing reasonable access in future health policy. The authors suggest that the implications of the current equity goals have not been recognized by policy makers, and if they were to be recognized it is not clear that they would be acceptable to Canadian populations and/or policy makers. Moreover, some of the implications would appear to be incompatible with other stated objectives of public policy.
-
In response to high drug prices, the Canadian government amended the country's patent act in 1969 to allow for compulsory licensing to import pharmaceuticals. As a result of the legislation, by 1983 drug costs in Canada were over $200 million lower than they would otherwise have been. The multinational drug industry was strongly opposed to compulsory licensing, despite any evidence that its economic position had been harmed. ⋯ The result was Bill C-22, which gave new drugs protection from compulsory licensing for seven to ten years. This article analyzes the impact of Bill C-22 on the generic industry, the creation of jobs in research and development, drug prices, and research and development expenditures. It concludes with an examination of future demands from the pharmaceutical industry.