Examining the Politics of Pharmacare: A Historical Institutionalist Perspective on the Development of Pharmacare Programs in Ontario and Quebec
Bibliographic record
Abstract
Canada remains the only developed country with a universal healthcare system that does not include nationwide coverage for prescription drugs. Only recently has the question of enacting a universal pharmacare plan come to fruition on the floor of the House of Commons. However, issues raised recently by provincial governments, including those of Ontario and Quebec, highlight concerns about the fiscal arrangements and operationalization of the first phase of Bill C-64, An Act Respecting Pharmacare, and the subsequent establishment of the Canada Drug Agency by the federal government. Through a cross-case analysis of existing pharmacare programs in Ontario and Quebec, I seek to determine how existing policy legacies and institutional structures have reshaped the political environment at the provincial level and have subsequently impacted the policy outcomes that may affect the prospect for contemporary federal reform for a national pharmacare program. This thesis employs a historical institutional approach to explain the trajectory of policy development as it concerns the politics of pharmacare in Canada. Following the work of scholars such as Paul Pierson on policy feedback (i.e., the impact of existing policy legacies on contemporary politics and policymaking), I analyze three types of political actors: elite attitudes, interest groups, and mass publics to determine how they have been affected by Canada’s fragmented system of drug financing, with a particular focus on Ontario and Quebec
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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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.022 | 0.018 |
| Scholarly communication | 0.008 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 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".