Canadian Fiscal Federalism, Regionalization, and the Development of Quebec's Health Care Delivery System

The availability of federal funding, or the limits of such funding, shape the parameters of “reform” at the provincial level within the Canadian health care delivery system and within the constraints of the Canada Health Act. We will examine how “fiscal federalism” sets parameters with respect to the “regionalization” reforms of provincial health care delivery systems and also influences such trends as “privatization” which are occurring in the Canadian provinces (and territories). Finally, after this contextual presentation, we will utilize the province of Quebec as a case study of the interface of developments in a provincial health care system and the context of the federal Canada Health Act and fiscal federalism.