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The Politics of Health Care … How Ottawa Governs

The Politics of Health Care … How Ottawa Governs. Association of Canadian Academic Healthcare Organizations 4th Annual Fall Invitational Conference Ottawa November 4, 2005. Four Questions. What do we think about the funding and delivery of health care in a post-Chaoulli world?

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The Politics of Health Care … How Ottawa Governs

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  1. The Politics of Health Care… How Ottawa Governs Association of Canadian Academic Healthcare Organizations 4th Annual Fall Invitational Conference Ottawa November 4, 2005

  2. Four Questions • What do we think about the funding and delivery of health care in a post-Chaoulli world? • How does the politics of health care mesh with the “productivity agenda”, federal-provincial relations and how Ottawa governs? • How do wait times, patient safety initiatives and the future of Academic Health Sciences Centres impact on the mission and mandate of members of ACAHO? • What is the role of research, innovation, and commercialization in relation to technology assessment?

  3. Advancing the Cause: • Health Care: Anatomy of an Issue • Diagnosis: Epidemic of Expectations • Prognosis: Prospects for a “Cure” • Prescription: Treatment Program

  4. Health Care: Anatomy of an Issue • personal and universal • visceral, ideological, now even class-driven • compelling though simplistic narratives, especially in media and in politics • the ultimate “wedge issue” especially in minority-government environment • politically, administratively and legally complex and interjurisdictional

  5. Diagnosis: An Epidemic of Expectations • intensely rivalrous competition for priority attention and resources: • among regions, provinces and cities • among causes, institutions, interest groups and personalities • surfeit of “good ideas” – limitless demand for resources • similar economic and social challenges of health care are common in other developed nations • many groups / organizations share similar pathology of failed advocacy • “Six Reasons Organizations Fail in their Attempts to Influence Government” or “Why Bad Things Happen to Good Ideas”

  6. Six Reasons Organizations Fail in their Attempts to Influence Government • They Ask for the Wrong Thing • They Get Active Too Late • They Ignore the Realities of Government Decision-Making • They Don’t Help the Government Think It Through • They Don’t Have a Champion in Government • They Stick with the “Same Old, Same Old”

  7. Incestuous Amplification: A condition in warfare when one only listens to those who are already in lock-step agreement, reinforcing set beliefs and creating a situation ripe for miscalculation" Janes Magazine

  8. Prognosis – Prospects for a “Cure” • forecast calls for continuing national denial and self-delusion about the economics, politics and allocative realities of modern health care • anything other than traditional publicly-funded and managed approaches continue to be “third rail” of Canadian politics at federal and provincial levels • search for made-in-Canada solutions will continue to be handicapped by the burden of the US metaphor • crisis-driven system causes occasional periodic lurches in priority setting; those prepared to be opportunistic will often be rewarded - usually to those that can show early results / progress • …. however, things can be done to improve prospects for advance

  9. “The definition of insanity is doing the same thing over and over again, but expecting a different result.” Albert Einstein

  10. “To have the results you’ve never had, you must do what you’ve never done.” Pierre Ducasse

  11. Prescription – Treatment Program • Emphasis on both “process” and “substance” and “expectations management” • Process: • recruit, commit and support key sponsors / champions • be opportunistic - prepared to quickly exploit situations • committed to “do-it-yourself-public-policy” • Substance • New Narrative • based on responsive political and public-policy insight • includes a picture of Canadian health care in 12 months, 3-years • Expectations Management • some early, easy “wins” with demonstrable results

  12. Sean Moore Partner / Public Policy Advisor Gowling Lafleur Henderson LLP 613-786-0216sean.moore@gowlings.com www.gowlings.com www.seanmoore.ca

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