Canada's Unique Approach to Public/Private Divide and the Perils of Reform Via a Court Challenge
Bibliographic record
Abstract
In both Canada and Japan court challenges are underway to allow a greater role for private payment. This article explains how Canadian courts to date have misunderstood the very different roles private payment (specifically private health insurance) plays across different health care systems. I illustrate this by situating Canada in a typology of health cares systems vis-a-vis the role for private health insurance. I argue that striking down existing laws restricting private payment in Canada’s system is not likely to result, as some argue, in Canada transforming into a “superior” European heath care system such as exists in France, the Netherlands, Germany, etc. Instead, the Canadian system will shift closer to a “Duplicate Private Health Insurance” model such as seen in New Zealand and England which is not likely to result in improvements in either equity or efficiency. I conclude that with the evidence base as complicated as it is, inevitably governments must exercise discretion in choosing how to organize and regulate a health care system, and courts - whether in Canada or Japan - should be extremely cautious of wading in to circumvent a government’s choices.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.031 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.029 | 0.033 |
| Scholarly communication | 0.024 | 0.007 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.017 | 0.016 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".