Accountability, Allocation, and an Aging Population: The Case for a Modified Canada Health Transfer
| dc.contributor.advisor | Mou, Haizhen | |
| dc.contributor.committeeMember | Yang , Yang | |
| dc.contributor.committeeMember | Hibbert , Neil | |
| dc.creator | Loerzel, Whitney Marie | |
| dc.creator.orcid | 0009-0000-1131-9146 | |
| dc.date.accessioned | 2024-09-23T17:37:54Z | |
| dc.date.available | 2024-09-23T17:37:54Z | |
| dc.date.copyright | 2024 | |
| dc.date.created | 2024-09 | |
| dc.date.issued | 2024-09-23 | |
| dc.date.submitted | September 2024 | |
| dc.date.updated | 2024-09-23T17:37:54Z | |
| dc.description.abstract | Canada is a decentralized federation wherein provincial governments are responsible for key policy areas such as healthcare. However, to assist provincial governments with their healthcare budgets, the federal government provides significant funding, including the Canada Health Transfer (CHT). Currently, the CHT is allocated to provinces on an equal per capita basis and grows with the national GDP growth rate (Canada, 2022). As Canada’s population ages, the provinces will need to pay for the increases in healthcare demand and expenditure. An aging population is as much a national policy issue as it is a provincial issue. Canadians can move about the country freely, and the Canada Health Act, 1984, contains a portability provision. As the current CHT allocation does not consider age in the calculation, the provinces with aging populations may not be receiving enough federal funding to prepare for and cope with healthcare service demand and costs. This mis-alignment of healthcare needs and healthcare funding generates accountability concerns. Federal and provincial/territorial governments shift blame to each other and Canadians cannot hold either government accountable for the quantity and quality of the healthcare services that they pay for and receive. This thesis examines the CHT from an accountability perspective and discusses whether and how the allocation of the CHT should be modified. Specifically, this thesis assesses why the CHT should incorporate healthcare-need indicators such as degree of population aging. Using multiple regression modeling, this thesis finds positive association between per capita provincial healthcare expenditure and various general trend indicators, including aging. This thesis uses the regression coefficient of the age indicator to construct a formula for age-based CHT top-up payments and compute payments provinces could receive in addition to the current equal per capita CHT payments. This thesis argues that an age-based top-up payment inclusion to the CHT will help strengthen the governments’ accountability to Canadians. These payments would use a clear, transparent formula and make information available to stakeholders. If the federal government provides this top-up funding, it would signal to Canadians that it is fulfilling its funding role and providing adequate healthcare funding. Provincial governments would then be left to manage their healthcare systems as needed. With this clearer division of responsibilities, voters would be able to reward or punish a government (federal or provincial) for their healthcare decisions and hold each level of government accountable. | |
| dc.format.mimetype | application/pdf | |
| dc.identifier.uri | https://hdl.handle.net/10388/16072 | |
| dc.language.iso | en | |
| dc.subject | Accountability | |
| dc.subject | Allocation | |
| dc.subject | Aging population | |
| dc.subject | Canada Health Transfer | |
| dc.title | Accountability, Allocation, and an Aging Population: The Case for a Modified Canada Health Transfer | |
| dc.type | Thesis | |
| dc.type.material | text | |
| thesis.degree.department | Johnson-Shoyama Graduate School of Public Policy | |
| thesis.degree.discipline | Public Policy | |
| thesis.degree.grantor | University of Saskatchewan | |
| thesis.degree.level | Masters | |
| thesis.degree.name | Master of Public Policy (M.P.P.) |