HIV testing in pregnancy: using women's voices to inform policy.

BACKGROUND: In Canadian provinces with opt-out policies for maternal HIV screening, pregnant women are told HIV screening is routine and are provided with the opportunity to refuse. In Newfoundland and Labrador an opt-out screening policy has been in place since 1997. PURPOSE: This research study aimed to (1) obtain an increased understanding of the information women receive about HIV/AIDS during the opt-out screening process and (2) to advance the policy related dialogue around best practices in HIV screening within the province of Newfoundland and Labrador. METHODS: Twelve women who were between 14 and 35 weeks gestation participated. Interviews were transcribed verbatim and a thematic analysis was carried out. FINDINGS: The major themes are that women have difficulty obtaining clear information about maternal HIV screening, are often not told they have the right to refuse maternal screening, and experience paternalism from physicians. CONCLUSION: We recommend that physicians and other health care providers in be reminded that that current opt-out testing requires women's consent and that women must be given the option to refuse the test.

Bennettcare to Medicare: the morphing of Medicare care insurance in British Columbia.

Introduced as a federal-provincial cost-sharing program in the 1960s, Canadian Medicare arose in the context of competing provincial models implemented by Saskatchewan, Alberta, and British Columbia. This article examines Bennettcare in British Columbia which, unlike the Saskatchewan and Alberta models, has never been analysed historically. Named after Premier W. A. C. Bennett, Bennettcare initially attempted to balance public support for a government-sponsored health insurance program with the free enterprise ideology espoused by the followers of Social Credit, the insurance industry, and the British Columbia Medical Association. However, in order to receive cost-sharing dollars from the federal government, Bennett was eventually compelled to change the design features in order to comply with the federal government's requirements of universality and public administration, morphing Bennettcare into Saskatchewan-style Medicare.