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Beyond the Binary: Acknowledging Complexity, Enabling Innovation and Preserving the Positive. 超越二元：承认复杂性，促进创新，保持积极。
HealthcarePapers Pub Date : 2025-06-01 DOI: 10.12927/hcpap.2025.27642
Peter Berman, Katherine Fierlbeck
{"title":"Beyond the Binary: Acknowledging Complexity, Enabling Innovation and Preserving the Positive.","authors":"Peter Berman, Katherine Fierlbeck","doi":"10.12927/hcpap.2025.27642","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27642","url":null,"abstract":"<p><p>In reviewing feedback on our article, we are reassured by the unanimity of concern about the current situation. However, there remains much oversimplification about what is meant by \"public\" and \"private,\" which undermines clearer thinking and innovation in practice. The confusion that results needs all our efforts to be removed. Canada's health system today holds much-deserved pride and praise. However, preserving and sustaining those accomplishments is in doubt, due in part to drivers of population need and change, which cannot be avoided, and in part to, in our view, somewhat misplaced rigidity and misunderstanding about the current situation and options going forward. We observe greater flexibility and innovation in other high-income countries. We urge learning from those innovations with a more open mind. May these exchanges move us a bit further along that path.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"23 1","pages":"47-51"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
New Law and More Money Cannot Fix Canadian Healthcare. 新的法律和更多的钱不能解决加拿大的医疗问题。
HealthcarePapers Pub Date : 2025-06-01 DOI: 10.12927/hcpap.2025.27643
Steven Lewis
{"title":"New Law and More Money Cannot Fix Canadian Healthcare.","authors":"Steven Lewis","doi":"10.12927/hcpap.2025.27643","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27643","url":null,"abstract":"<p><p>Canadian healthcare consistently underperforms. The <i>Canada Health Act</i> (1985) is far from ideal, but it has never been the main impediment to system improvement, and updating or replacing it has limited potential to effect transformational change. It is impractical to shift from a Beveridge-style tax-funded system to a Bismarckian social insurance approach. Improvement requires better policy, incentives aligned with goals and accountability for performance. The key ingredients are wisdom and courage.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"23 1","pages":"41-45"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
We Need to Do the Hard Work to Strengthen Public Healthcare. 加强公共卫生工作任重道远。
HealthcarePapers Pub Date : 2025-06-01 DOI: 10.12927/hcpap.2025.27645
Joss Reimer
{"title":"We Need to Do the Hard Work to Strengthen Public Healthcare.","authors":"Joss Reimer","doi":"10.12927/hcpap.2025.27645","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27645","url":null,"abstract":"<p><p>Canada's healthcare system is at a crossroads. After years of declining performance, there is growing pressure to consider more radical changes in the way it is funded and delivered, including increasing the scope of private options. But the Canadian Medical Association's engagement with more than 10,000 physicians, patients and members of the public - through surveys, town halls and focused dialogues - revealed that accessible healthcare, regardless of the ability to pay, remains a bedrock value. We need to continue the hard work of strengthening the public health system to ensure that it meets Canadians' evolving health needs.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"23 1","pages":"32-35"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is There a Third Way for Healthcare in Canada? 加拿大的医疗保健还有第三条路吗？
HealthcarePapers Pub Date : 2025-06-01 DOI: 10.12927/hcpap.2025.27648
Katherine Fierlbeck, Peter Berman
{"title":"Is There a Third Way for Healthcare in Canada?","authors":"Katherine Fierlbeck, Peter Berman","doi":"10.12927/hcpap.2025.27648","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27648","url":null,"abstract":"<p><p>The framework for publicly insured healthcare in Canada was established in the middle of the twentieth century with the 1957 <i>Hospital and Diagnostic Services Act</i> and the 1966 <i>Medical Care Act</i>. These statutes were consolidated in 1984 as the <i>Canada Health Act</i> (CHA) (1985). The key provision of this legislation was the stipulation that medically necessary healthcare provided in hospitals, or by physicians, was to be publicly insured. The point was to provide access to medically necessary healthcare independent of the ability to pay. This commentary suggests that the contours of healthcare in Canada have shifted substantially since the development of medicare and that, because of these changes, the CHA (1985) no longer facilitates either accessibility or equity. Owing to the \"deep but narrow\" provision of healthcare services, key aspects of contemporary healthcare (including pharmaceuticals and mental healthcare) are often not publicly insured. At the same time, because of changes in who provides medically necessary care, and where and how it is provided, many Canadians are increasingly able to access these services independently of public insurance. Somewhat paradoxically, the rigid structure of the CHA (1985) has both diminished access to publicly insured healthcare, on the one hand, and has permitted the emergence of two-tier healthcare, on the other. Achieving better access to, and equity in, healthcare provision will require a fundamental rethinking of the nexus between federal funding mechanisms and the regulatory landscape in the provincial/territorial [ PT] domain.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"23 1","pages":"8-19"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Piercing the Public-Private Debate: An Asset-Based Approach to Transforming Canadian Healthcare. 穿透公私辩论：以资产为基础的方法来改变加拿大的医疗保健。
HealthcarePapers Pub Date : 2025-06-01 DOI: 10.12927/hcpap.2025.27644
Danyaal Raza
{"title":"Piercing the Public-Private Debate: An Asset-Based Approach to Transforming Canadian Healthcare.","authors":"Danyaal Raza","doi":"10.12927/hcpap.2025.27644","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27644","url":null,"abstract":"<p><p>Canadian healthcare faces a myriad of challenges. Debates focused on reform often occur within the \"public vs. private\" paradigm, despite a body of evidence that has largely resolved the issue. Thus, the debate is not one of evidence; it is political. Piercing this debate can occur through a return to values, operationalizing them via design and adopting an assets-based approach. Challenges to reform cannot be ignored, including recognizing material realities. No matter what form changes to the healthcare system take, considerable social and political capital will be required for reform.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"23 1","pages":"36-40"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
We Should Not Settle for Mediocre Medicare. 我们不应该满足于平庸的医疗保险。
HealthcarePapers Pub Date : 2025-06-01 DOI: 10.12927/hcpap.2025.27649
Audrey Laporte, Sara Allin
{"title":"We Should Not Settle for Mediocre Medicare.","authors":"Audrey Laporte, Sara Allin","doi":"10.12927/hcpap.2025.27649","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27649","url":null,"abstract":"<p><p>There is an overwhelming body of evidence documenting the failure of our health systems in Canada. Also, there are compelling comparative data showing that, despite similar challenges faced by health systems around the globe, Canada consistently underperforms relative to its peers on both healthcare quality and health outcomes.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"23 1","pages":"5-6"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Canada Can Find a Third Way, but Private Insurance Is Not a Silver Bullet. 加拿大可以找到第三条路，但私人保险不是灵丹妙药。
HealthcarePapers Pub Date : 2025-06-01 DOI: 10.12927/hcpap.2025.27646
Zeynep Or
{"title":"Canada Can Find a Third Way, but Private Insurance Is Not a Silver Bullet.","authors":"Zeynep Or","doi":"10.12927/hcpap.2025.27646","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27646","url":null,"abstract":"<p><p>Canada's public healthcare system grapples with persistent challenges, including long waiting times and limited coverage for essential services. Fierlbeck and Berman propose a \"third way\" for Canadian healthcare, which involves a greater role for private service provision and private insurance, alongside improved price controls and efficiency measures. While they provide many sensible policy ideas, several critical issues require clarification, particularly the definition of private insurance, the scope of services it would cover and the potential financial impact on low-income populations. Rather than leaning heavily on private insurance and market-based solutions, expanding the public benefits package and reinforcing regulatory frameworks for integrating private capacity would be more equitable and sustainable paths forward.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"23 1","pages":"26-31"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is a Third Way Enough to Tame Hidden Forces? 第三种方法足以驯服隐藏的力量吗？
HealthcarePapers Pub Date : 2025-06-01 DOI: 10.12927/hcpap.2025.27647
Benoit Morin
{"title":"Is a Third Way Enough to Tame Hidden Forces?","authors":"Benoit Morin","doi":"10.12927/hcpap.2025.27647","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27647","url":null,"abstract":"<p><p>The lead article interestingly suggests that there might be a third way between publicly funded health systems and profit-driven private offerings. Securing the principles of universality and equity underpinning the <i>Canada Health Act</i> (1985) is at stake. However, healthcare cost is growing at a pace that is not sustainable; all the while, our health systems fail to keep up with demand. No matter how useful a third way system may prove to be, can it be a complete and sustainable solution? Deeper societal questions such as universality's affordability may also need to be answered. Built-in forces driving healthcare costs up, such as profit-driven research and development of all kinds, medical science advancement and population needs keep increasing costs unsustainably higher. What should we do? This commentary builds on the lead article to help reflect on the matter. Protecting universality and equity may mean redefining them in order to tame powerful hidden forces at play.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"23 1","pages":"21-25"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Through the Nursing Lens: How AI Will Change Healthcare Practice and Professions. 透过护理镜头：人工智能将如何改变医疗保健实践和专业。
HealthcarePapers Pub Date : 2025-04-01 DOI: 10.12927/hcpap.2025.27573
Tracie Risling, Gillian Strudwick
{"title":"Through the Nursing Lens: How AI Will Change Healthcare Practice and Professions.","authors":"Tracie Risling, Gillian Strudwick","doi":"10.12927/hcpap.2025.27573","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27573","url":null,"abstract":"<p><p>The influence of artificial intelligence (AI) is driving transformation in healthcare systems in parallel with similar disruption in other sectors and society at large. In this article, we draw on Kueper and Pandit's (2025) paper to emphasize that this global infusion of AI requires immediate attention from the world's largest group of healthcare practitioners. Nurses have a critical role to play not only in how this technology will change healthcare delivery and their professional practice but also in how it will change the world. Promising nursing-led AI initiatives include improved clinical decision making and prediction, personalized care, digital documentation and resource allocation.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"22 4","pages":"32-38"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tipping the Balance Toward Positive Futures for Patients: AI in Healthcare. 为患者的积极未来打破平衡：医疗保健中的人工智能。
HealthcarePapers Pub Date : 2025-04-01 DOI: 10.12927/hcpap.2025.27566
Jennifer Zelmer, Annette McKinnon
{"title":"Tipping the Balance Toward Positive Futures for Patients: AI in Healthcare.","authors":"Jennifer Zelmer, Annette McKinnon","doi":"10.12927/hcpap.2025.27566","DOIUrl":"https://doi.org/10.12927/hcpap.2025.27566","url":null,"abstract":"<p><p>Artificial intelligence (AI) has the potential to improve the patient and provider experience, contribute to better health outcomes, and strengthen the productivity and sustainability of health systems and advance equity. Or to do the opposite. A policy lab involving diverse interest holders identified four guiding principles to help tip the balance toward positive outcomes. Participants noted the importance of bearing in mind the unique characteristics of AI as a technology, right-sizing its use, co-designing solutions and ensuring a focus on equity. The paper also includes reflections from an experienced patient partner on how these core principles apply from her perspective.</p>","PeriodicalId":101342,"journal":{"name":"HealthcarePapers","volume":"22 4","pages":"74-77"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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