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Measuring Shrinkage in the Welfare State: Forms of Privatization in a Canadian Health-Care Sector

Published online by Cambridge University Press:  30 January 2006

Alina Gildiner
Alina Gildiner
Affiliation:
McMaster University
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Abstract

Abstract. There is a discussion in the literature about whether, to what extent, and in what ways the welfare state is retrenching or otherwise changing. Both the health policy literature and the broader policy studies literature have tended to focus on economic measures of privatization. This study tests the adequacy of the measures of public-private change proposed by Stoddart and Labelle (1984) by using them to track and analyze the sequence of policy changes in automobile legislation, workers' compensation and health that transformed Ontario's rehabilitation health sector from being almost entirely public in 1990 to being almost entirely private a decade later. It suggests adding what is called “allocative decision-making power” to indicators used to assess public-private change in order to more adequately capture transformations.

Résumé. Assiste-t-on au déclin de l'État-providence ou à sa transformation? Quelle est l'ampleur du phénomène? Ce sont des questions qui ont été maintes fois examinées. Or, les analyses des politiques de santé ainsi que les études plus générales des politiques publiques ont tendance à se concentrer sur les mesures économiques de privatisation. La présente étude vise à tester la pertinence des mesures du changement public-privé proposées par Stoddart et Labelle (1984) en les appliquant à la série des changements de politiques en matière de réglementation automobile, d'indemnisation des travailleurs et de santé qui ont fait passer le secteur de la réadaptation du système de santé ontarien d'un statut presque entièrement public en 1990 à un statut presque entièrement privé une décennie plus tard. Cette étude propose d'ajouter la mesure de ce qu'on appelle “ la capacité à prendre des décisions d'allocation ” aux indicateurs traditionnels d'évaluation de l'équilibre public-privé, afin de mieux décrire les processus de changement.

Type
Research Article
Information
Canadian Journal of Political Science/Revue canadienne de science politique , Volume 39 , Issue 1 , March 2006 , pp. 53 - 75
Copyright
© 2006 Cambridge University Press

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