Capacity, costs, and control, health care policy in Manitoba from 1948 to 1988
Carrothers, Leslie C.
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The focus of this study is the evolution of health care policy in Manitoba from 1948 to 1988. The time frame covers two periods in this province's policy history: the period between the end of World War II and 1969 when the primary policy goal was increasing the capacity of the province's health care delivery system; and the period between 1969 and 1988 when the primary policy goal was containment of growth in delivery system costs. Utilizing a mix of qualitative and quantitative measures this study assesses the types of, impacts related to, and causes of health care policy change during the tenure of six government administrations in the province. The findings indicate that while policy changes at the federal level influenced the timing of provincial policy changes, the interests of and intermediation between key actors in Manitoba's health care policy community played a critical role in the way each administration approached the formation and implementation of cost control policy. In short, this study supports neo-pluralist assumptions that the interplay between executive council actors and key provider pressure groups is an important factor in the nature and direction of provincial health care policy change. It also suggests that the content of public policy debates pertaining to changes in delivery system capacity and costs are directly related to the distribution of organizational authority among key actors in a province's health care policy community.