The second paper in this issue of Longwoods Review is entitled Strangulation or Rationalization? Costs and Access in Canadian Hospitals by Morris L. Barer, Steven G. Morgan and Robert G. Evans. The authors describe a period beginning a decade ago when Canadian hospitals first experienced the most severe fiscal restraint of the past half-century. Between 1992 and 1996, hospital expenditure per capita fell sharply, from $939 to $858. These cuts fuelled professional declarations - and a swarm of anecdotes - about the dire consequences for the health of Canadians. Confidence in the healthcare system dropped precipitously. Yet, a series of royal commissions and similar inquiries later concluded that there was substantial scope for rationalization and cost-containment within the provincial hospital systems. This paper examines the statistical record, looking at hospital capacity, access and utilization, prior to, during and after the 1990s reductions, and the impact of provincial finances on hospital-funding decisions. The authors advise that provincial governments should not be tempted to continue with hospital and other healthcare services budget cuts or the system will become rapidly unsustainable.
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About the Author(s)
Peggy Leatt, PhD
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