Roundtable:
Policy Waivers to Enable Improvements in Health Care Coverage and Delivery: Applications to Canada
(Global Health Policy)
*Names in bold indicate Presenter
The performance of the Canadian health system has fallen behind international counterparts on measures of service access, patient-centered delivery, and cost efficiency. Canadian policymakers recognize that provincial health systems need to update how they finance and deliver care to meet the needs of today's patients, including by incorporating new information and medical technologies. However, provinces have implemented few lasting expansions of insured services or system-wide changes to delivery systems, despite the recommendations of blue ribbon commissions. Health policymakers need evidence-informed, well-demonstrated strategies for accomplishing reform. This roundtable will describe how policy waivers have been used to test and spread a range of significant health system reforms in comparator countries and to explain how similar waiver authority can be applied in the Canadian context. Roundtable speakers have been leaders in designing, implementing, and evaluating health policy waivers, particularly in federal health systems. The first speaker will define policy waivers, describe a framework for categorizing them, and share information from the United Kingdom and France about how those two health systems enable experiments in the financing and delivery of health care. The next two speakers, who are both practitioners and academic researchers, will discuss how the United States' extensive experience with waivers in its federal-state Medicaid program could be applied in Canada's provinces. Specifically, the first will explain how Medicaid "section 1115" reform demonstrations could inform Ontario's implementation of integrated care systems and the latter will present the risks and rewards of implementing national pharmacare in Canada through waiver demonstrations.
