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In the fall of 2014, the Government of Canada formally split the role of the Chief Public Health Officer (CPHO) into two positions: the CPHO and the President of the Public Health Agency of Canada. Despite concerns raised by the public health community, these changes are consistent with the CPHO's authority. However, the nature of responsible government means that the CPHO cannot simultaneously serve as an independent advocate for policies and programs that might prevent disease and as a senior advisor to the government of the day. [ABSTRACT FROM AUTHOR]

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In January 1997, the government of Quebec, Canada, implemented a public/private prescription drug program that covered the entire population of the province. Under this program, the public sector collaborates with private insurers to protect all Quebecers from the high cost of drugs. This article outlines the principal features and history of the Quebec plan and draws parallels between the factors that led to its emergence and those that led to the passage of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) in the United States. It also discusses the challenges and similarities of both programs and analyzes Quebec's ten years of experience to identify adjustments that may help U.S. policymakers optimize the MMA. [ABSTRACT FROM AUTHOR]

Analyzes past experiences and future prospects of obtaining public input for health-systems decision-making in Quebec and Ontario. Structure and mandate of the regional health and social services boards and district health councils; Designing processes followed by the Quebec health authority decision-makers; Constraints faced by the authorities in mounting public consultation processes.

The article discusses the need to turn attention to issues that are critical to the future of public deliberation practice such as broadening the reach and scale of public deliberation, increasing acceptability to policymakers, and integrating it into policy decisions. Public deliberation efforts must be undertaken on a bigger scale. Public deliberations that work inside the system to be effective, must be formed, timed, and located in ways that can productively relate to policy processes.

The article discusses the concept of public deliberation and that is value-based in that it seeks to determine what ought to be done in response to a particular issue or a challenge that requires citizens to identify, clarify, and weigh the tensions among their views and the values underlying them; justify them to others; and set priorities. The need to understand that public deliberation is especially transformative wherein insight is gained is highlighted.