Institute of Intergovernmental Relations


Paradigm Freeze Why It Is So Hard to Reform Health-Care Policy in Canada

Paradigm Freeze Book Cover

Health care in Canada and its future has been a political and policy priority issue for Canadians over the last three decades. During this period (especially the first two decades), almost all provincial governments appointed one or more arms length commissions of enquiry, task forces or advisory bodies to diagnose the health of health care in Canada. These bodies were asked to analyze the strengths and weaknesses of health care in their jurisdiction and to recommend cures for its ailments. The federal government did likewise. While these numerous reports differed on some issues, what stands out more strongly was the commonality of their diagnoses and their proposals for cure.

Yet there is widespread consensus that governments have undertaken relatively little reform over these decades. The status quo by and large prevails. What accounts for the meagre health-care policy reform over these years? This question is at the heart of a new book produced by the Institute of Intergovernmental Relations -- Paradigm Freeze: Why It Is So Hard to Reform Health-Care Policy in Canada.The book is based on 30 case studies that cover the period from 1990 to 2003 and then extend to 2011. Using cross-issue, cross-governmental, and cross-political analyses, the book identifies the mix of factors that impede health-care policy reform and the mix that support reform.

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Former Institute director Harvey Lazar is principal editor of this volume.