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Colleen M Flood

Publications and source records attributed to Colleen M Flood.

10 recordsLinked to original sources
PubMed2005

Steering and rowing in healthcare: the devolution option.

Claims of"underfunding" notwithstanding, the problems we are experiencing with healthcare in Canada are primarily attributable to a deficiency of governance of our ill-coordinated non-system of health and healthcare services.

Administrative Personnel↗
PubMed2004

How does private finance affect public health care systems? Marshaling the evidence from OECD nations.

The impact of private finance on publicly funded health care systems depends on how the relationship between public and private finance is structured. This essay first reviews the experience in five nations that exemplify different ways of drawing the public/private boundary to address the particular questions raised by each model. This review is then used to interpret aggregate empirical analyses of the dynamic effects between public and private finance in OECD nations over time. Our findings suggest that while increases in the private share of health spending substitute in part for public finance (and vice versa), this is the result of a complex mix of factors having as much to do with cross-sectoral shifts as with deliberate policy decisions within sectors and that these effects are mediated by the different dynamics of distinctive national models. On balance, we argue that a resort to private finance is more likely to harm than to help publicly financed systems, although the effects will vary depending on the form of private finance.

Cost Sharing↗
PubMed2004

Devolution--a solution for Ontario: could the lone wolf lead the pack?

In response to what we describe as the "accountability gap" in healthcare, nine provinces have embraced the devolution of management responsibility and authority from central government administrations to regional health authorities. Ontario, Canada's most populous province, is the lone wolf. This commentary focuses on the consequences of Ontario's reluctance to adopt devolution. The authors argue that devolution is an important first step in improving the lines of accountability within publicly funded healthcare; however, as a reform initiative, devolution must form part of a series of interlocking initiatives. These complementary reforms include refocusing the debate from funding (money) to governance, clarifying the governance roles of both the federal and provincial governments and developing an incentive- and information-based system that is geared more to rewarding gains in healthcare outcomes as opposed to the delivery of health services. With a new government in Ontario, there is now a window of opportunity to capitalize on the experiences and failures of other provinces and for Ontario to emerge as the leader of the pack, rather than the lone wolf.

Canada↗
PubMed2002

The Mazankowski Report: can we fix medicare with more private financing.

The Mazankowski Report is a very important contribution to the debate washing over Canada with regard to the future of its most cherished social program, medicare. While a complete analysis of the report is not possible in this brief comment, several observations and arguments should be made. First, the report's recommendations for a greater role for private financing undermines the other excellent recommendations made with regard to greater accountability, the rigorous pursuit of quality and greater flexibility regarding the role of the private sector in delivery (as opposed to financing). Second, the report's specific recommendation to establish a permanent, independent panel to determine what services should and should not be publicly funded is a worthwhile reform, but not for the reasons envisaged by the report's authors - that is, because it will result in a reduction in the range of services funded and save public dollars. Rather, it is a worthwhile initiative because engaging in a transparent and explicit determination of what is in and out of the publicly funded basket is likely to result in more political support for publicly funding a wide range of care rather than less.

Alberta↗