Since the 1980s, privatization has been a central characteristic of health care reforms in Canada. Privatization is not a single or simple process, but a philosophy and set of practices which blur the lines between public and private sector ownership and responsibility. It may take the shape of user-fees, deductibles and other forms of private payment for health services. Elsewhere, it may take the form of de-listing health services from the public health insurance system or decreases in the amount and types of care provided in hospitals.

Recognizing women as the majority of health care providers and receivers in Canada, the Women and Health Care Reform group commissioned a set of papers from the Centres of Excellence in Women’s Health to examine the potential effects of health care reforms and privatization on women across Canada. This research demonstrated that while privatization is typically seen as an economic concept, there are social aspects that must also be considered.

Specifically, women are paying the price through the privatization of costs, care work, responsibility, service delivery and managerial practices. The average lower incomes and higher poverty rates of Canadian women in comparison to men mean that they are less likely to have the financial resources to compensate for the privatization of health care costs. Since it is women who continue to be responsible for the majority of unpaid and paid care work, it is women who are particularly affected by declines in hospital spending and institutional care. It is women who compensate financially and socially for shifts from institutional to community-based and home care, and it is women who must cope with understaffing, heavier workloads and increased levels of stress and injury in the workplace that has been tied to the adoption and implementation of private sector management principles throughout the health care sector.

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