Public Policy - Theses, Dissertations, and other Required Graduate Degree Essays

A universal prescription drug coverage policy remains an unfinished business of Canadian healthcare system with over sixty year long historical roots. Since national medicare doesn’t provide prescription drugs outside of hospitals, provinces and territories have independently developed public drug insurance programs (primarily for seniors and the poorest on social assistance) under various eligibility and patient cost-sharing arrangements. The absence of universal public coverage inevitably created a large role for private financing of prescription drugs by means of a variety of costly private insurance plans and out-of-pocket payments that many Canadians cannot afford. This situation has by now driven the system to a crisis point where the phenomenon of fast-rising costs of medically necessary drugs has added further adverse effects on public health, in terms of reduced equity of access and lost socio-economic wellbeing. It costs the health system billions of dollars downstream by requiring additional visits to physicians and resulting hospitalizations as patient health conditions deteriorate due to cost-related non-adherence to prescriptions. In the past a number of attempts towards making a national pharmacare failed and the status quo with a confusing patchwork prevailed. Of late, the federal government has taken a sincere initiative to implement a universal drug coverage plan inclusive of some measure of user-charge. This study evaluates the likely impact of different types of patient charges in a public system of prescription drug coverage for Canada. Employing qualitative and quantitative methods of analysis, it examines both primary and secondary data to evaluate the three policy options considered in this study. Taking all aspects into account, reasonable policy recommendations are made to make an affordable and efficient prescription drug coverage for all Canadians with the aim of reducing cost-related non-adherence to prescriptions, providing improved access to medications and, in the end, to achieve better health outcomes.

Indigenous peoples have maintained that sovereignty over their waters is a priority for them. Yet, most water governance systems across Canada exclude Indigenous peoples from decision-making processes over the waters that sustain them. There is growing recognition across water practitioners and watershed users that this needs to change. In BC, the modernization of the province’s water laws through the introduction of the Water Sustainability Act has enabled a suite of water governance tools that show potential to be leveraged to support Indigenous water governance. This paper draws on a literature review, expert interviews, and case studies to analyze how select tools in the Water Sustainability Act could be used to further Indigenous sovereignty over water. Then, it provides recommendations to the BC Government on areas of action that would enable or assist with the uptake of water governance tools by Indigenous peoples.

This project explores the role of client criminalization in shaping the health, safety and human rights of sex workers and evaluates potential policy options to improve the occupational health and safety of sex workers in Canada. As part of a longstanding community-based study (An Evaluation of Sex Workers’ Health Access; AESHA) this capstone draws on 47 in-depth qualitative interviews with sex workers and third-parties in indoor venues between 2017-2018, as well as a literature review on client criminalization and previously adopted policy interventions in various settings. A range of policy options were identified to address sex workers' occupational health and safety, including decriminalization, legalization and the adoption of a police agreement to end the targeting of sex workers, and were evaluated against selected criteria. Findings suggest that the elimination of punitive, enforcement based approaches to sex work towards decriminalization, is expected to have the greatest impact on improving sex workers' health and safety. Notably however, anti-sex work opposition remains a significant barrier in implementing decriminalization in Canada. Considering the time, effort and political will required to create an appropriate decriminalization model, the recommendations of this analysis are two-fold: (1) immediately eliminate unrequested police involvement in the sex industry and implement a Good Samaritan law to provide sex workers with the space to define a decriminalization model without the threat of punitive policing; (2) take the time to directly include and consult with the sex work community to establish a decriminalization framework that meets the needs of Canadian sex workers.

Black youth in Canada experience poor labour market outcomes compared to other Canadian youth. Data shows that Black youth experience a higher unemployment rate, lower employment rate and lower earnings compared to other Canadian youth. Using a literature review, case study analysis and expert interviews, this study identifies key labour market barriers Black youth face and policy options to address them. The barriers identified include socioeconomic, educational and discrimination, both during the job search and during employment. The study makes a case to focus on education and discrimination as the two significant barriers. The options evaluated include using mentorship programs for Black youth in secondary school and in post-secondary institutions, adopting AI technology in the hiring process and initiating workplace solutions such as anti-racism training and mentorship. The study concludes with the recommendation to implement mentorship programs at the secondary and post-secondary level to address the educational barriers Black youth face, which in turn affects their labour market outcomes.

The region of Northern Ontario has experienced prolonged socio-economic decline since the 1980s, and the continuation of these trends presents a threat to the sustainability of communities in the region. This study argues that current regional economic development policy for Northern Ontario has been ineffective in promoting sustainable development. Using a comparative case study analysis, involving secondary data collection, a review of academic and grey literature, and a jurisdictional scan, the region is placed in a broader Canadian context. Three policy options are identified and analyzed based on their ability to effectively promote sustainable development in the region, their cost, their ease of implementation, and their political viability. It is recommended that the federal government increase funding through the Federal Economic Development Initiative for Northern Ontario (FedNor) by implementing an Indigenous-focused program in the near term, while engaging the Government of Ontario to implement collaborative Regional Economic Planning Agencies in the long term.

With a rising immigrant population in Canada, it is increasingly important to ensure positive socioeconomic outcomes for all immigrants. Their ability to achieve positive outcomes is hindered by intimate partner violence (IPV), the victims/survivors of which are more likely to be women. Although all women experiencing IPV share some common experiences, immigrant women face unique structural barriers to seeking and accessing formal supports for IPV arising from their position at the intersection of gender, race, class, and immigration status. This study identifies the structural barriers faced by immigrant women, including women with precarious immigration status, and provides three policy options to improve their access to formal supports. Given the important role of the federal government in immigration policy and more recently in anti-violence initiatives through its Gender-Based Violence Strategy, recommendations are provided for the federal government to ultimately ensure safety for all immigrant women.

Precarious work is a growing form of employment associated with low-pay, job insecurity, income volatility, unsafe working conditions, and a lack of access to training opportunities among other conditions. These conditions are damaging for all who work in precarious employment and yet, research finds women are disproportionately represented in this type of work. As a result, women may be more likely to face socio-economic challenges in the short and long-term, including having limited access to training opportunities. Given the limited research on precarious workers’ abilities to access training opportunities, this study further explores this challenge while focusing on women. A series of policy options are analyzed and compared to provide a recommendation for how to improve access to training opportunities for women in precarious work.

Policymakers are increasingly recognizing the ways in which Indigenous Knowledge can complement Western science to improve our understanding of and response to important issues such as climate change. Despite this, there are few areas where Indigenous Knowledge is currently being applied in decision-making by non-Indigenous governments. The goal of this paper is to explore concrete ways that Indigenous Knowledge could be respectfully and appropriately included in climate adaptation decision-making at the provincial level. Based on a literature review, an environmental scan, expert interviews, and examples from across Canada, I first identify key principles that should guide government policies relating to Indigenous Knowledge. I then propose a framework with specific policy examples for how Indigenous Knowledge could be applied to climate adaptation and resilience planning in BC.

Public transportation is crucial in helping to grow cities sustainably. Good public transportation allows for less car-dependence, healthier and less polluted communities, and more equitable communities. Within BC’s Lower Mainland, the current lack of inter-regional transit options, combined with the high level of congestion, pollution, and growing population in the Fraser Valley and Metro Vancouver’s eastern communities presents opportunities to explore different methods to better connect the Fraser Valley and Metro Vancouver with mass transit. The study looks at data from a jurisdictional scan and expert interviews to analyze several different inter-regional transit proposals that have been discussed within the Lower Mainland. The findings can help to aid urban planning within the Lower Mainland and look at how to best address this gap in the region’s transportation infrastructure.

Incarcerated individuals are more likely to deal with mental health challenges than the broader Canadian public. Mental illness can be a contributor to criminal behaviour, while the experience of incarceration can exacerbate underlying mental health conditions. However, there are limited existing supports for these incarcerated individuals, meaning that offenders may become trapped in vicious cycles of recidivism linked to ongoing mental health challenges. This study explores what might be done to this policy problem in Canadian correctional facilities. Drawing on existing literature, case studies and a series of expert interviews, the study presents, and evaluates, four possible policy paths forward. The analysis supports three policy recommendations to begin to tackle this issue: transferring healthcare responsibilities to provincial Ministries of Health; introducing mandatory mental health training for staff; and creating a community program liaison officer pilot project.