Provincial Inquiries into
Health Care Organization
As the federal cost constraints began to bite after the introduction of the Established Programs Financing Act (EPF) and subsequent revisions of federal transfer policies, particularly in the poorer provinces, some governments decided to consult the public about their ideas on how to ration services. This was more obvious in the Atlantic provinces than elsewhere (New Brunswick 1978). Newfoundland, for example, instituted three inquiries (e.g., Newfoundland 1984), one of which, called the Green Paper on Our Health Care System: Expenditures and Funding (Newfoundland 1986), expressed great concern about the province's ability to continue to provide the current level of health services. The government asked for the voters' views on the options — increase privatization, reduce expenditures, engage in deficit financing or change the tax system.
Nova Scotia addressed this cost control issue in a different way. A legislative committee (Nova Scotia 1984) examined how to cut down on hospital use in smaller communities (Doane 1990).
Some provinces preferred to use public inquiries, others decided to rely on their bureaucrats for advice. Manitoba seemed to believe in using consultants to prepare background papers for its policy discussions. In the mid 1980s the government commissioned studies of its medical plan (Roch and Evans 1985) and its mental health services (Manitoba Health 1984) before making a general health services review (Manitoba 1988a).____________________