In Alberta, decision-making in the health system has been devolved to
seventeen Regional Health Authorities (RHAs). This thesis undertakes a broad
analysis of the values that underlie this regionalization.
Divided into two parts, the first half of the thesis develops a liberal
egalitarian theory for the distribution of resources in society that turns on the
importance of providing all people with the basic resources required to plan for,
develop and achieve their life goals. Four requirements for any health system
that seeks to uphold the values inherent in this theory are then articulated.
These requirements include the need for the health system to be sensitive to the
broader determinants of health, and the need for understanding the concepts of
health and disease within the context of the social and cultural communities
that the system is meant to serve. Part One concludes with an argument
suggesting that expressions of Canadian values cohere with the normative
theory developed.
In Part Two the evolution of Alberta's regionalized healthcare system is
traced. The values implicit in the regionalization of the health system in this
province are then examined for their congruence with the four requirements
developed in Part One. Following this, the ethical difficulties faced by RHAs are
considered. The thesis culminates with thoughts on the ethical challenges
Alberta's regionalized healthcare system must confront, offering
recommendations for how some of these challenges may be addressed. It is concluded in the thesis that while a regionalized health system is not
necessary for meeting the requirements elucidated, these standards can be met
with a regionalized approach. However, at least in the case of the Alberta
experience, a number of important changes would have to take place for this to
occur. Among these changes is a paradigm shift in the way health and disease
are understood towards a more evaluative approach; the recentralization of
public health initiatives to the provincial level; and an overall change in
governmental health policy recognizing that many areas of society, and
consequently the policies of government agencies beyond a disease-based
healthcare system, impact health and well-being.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:BVAU.2429/8160 |
| Date | 11 1900 |
| Creators | Jiwani, Bashir |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Relation | UBC Retrospective Theses Digitization Project [http://www.library.ubc.ca/archives/retro_theses/] |
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