Saskatchewan’s Health-Care Policy Reform in the Romanow Era: From Restraint to Restructuring
Bibliographic record
Abstract
saskatChewan's heaLth-Care PoLiCy reform in the romanow era: from restraint to restruCturing tom mCintosh and miChaeL duCie introduCtion This chapter examines the nature and extent of health reform decisionmaking in the province of Saskatchewan during the premiership of Roy Romanow, who led the province from 1991 until his resignation a decade later.The early 1990s saw the beginning of the greatest period of healthcare reform since the adoption of publicly funded medical insurance by Saskatchewan in 1962.Like the other four provinces covered in this volume, however, Saskatchewan also chose to impose stringent restraints on public spending in response to growing levels of debt.As is discussed more fully below, the budget restraints had a significant impact on the province's health reform plans.The reforms began in 1991 with the election of Roy Romanow's left-of-centre New Democratic Party (NDP) government and were, for the most part, introduced within the first three years of his administration; however, developments continued throughout his time in office, as aspects of the reform program were refined and the social and economic situation within province improved.Six specific health policy reform decisions are examined in this study.These decisions begin with Romanow's first provincial budget and carry on throughout his tenure and into that of his successor, Lorne Calvert.The first decision, to cut access to the once generous provincial drug plan, came about because of specific economic circumstances in the province.The next three decisions-the creation of a regionalized governance structure, the attempt to move to population needs-based funding for health services, and the attempt to move physicians away from fee-for-service payments-were part of an explicitly articulated vision of health reform that eventually became known as the "wellness agenda."The passage of
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.006 | 0.006 |
| Scholarly communication | 0.006 | 0.001 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.004 |
| 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".