Access to medical care under strain: New pressures in Canada and Australia

Health policy changes intended to achieve cast control in OECD countries ru n the risk of reintroducing financial barriers to health care. However, alt hough the problems faced are similar, different countries are dealing with the situation in different ways. For example, Canada and Australia, which s hare many similarities, have taken quite different policy paths in the last decade: Canada has preserved universal access, whereas Australian policy i s promoting a two-tier system through the provision of public subsidies far private insurance. The evidence is that country-specific factors such as i nstitutional arrangements, attitudes, and values intersect with economic an d financial factors to shape policy outcomes. Moreover, the Canadian and Au stralian experiences suggest that in relation to access issues, attitudes a nd values are the key policy determinants.