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McMaster Health Forum | Ontario's Health System


Ever wonder how the Ontario health system works? You can find answers in a book edited by the McMaster Health Forum’s director, entitled ‘Ontario’s health system: Key insights for engaged citizens, professionals and policymakers’. The goal of this book is to help make the system more understandable to the citizens who pay for it and are served by it, the professionals who work in it (and future professionals who will one day work in it), and the policymakers who govern it. Each chapter begins with key messages for each of these groups.

The introduction of Ontario Health Teams (OHTs) is part of a wave of significant changes being made to Ontario's health system now. For a brief description of the changes anticipated with the introduction of OHTs, as well as a brief overview of significant changes that have been made to Ontario’s health system since December 2016, read the RISE brief on Ontario's health system.

Book and ebook

You can purchase a hard copy of the book on (or for individuals outside of Canada, on

You can purchase the ebook (372 MB) through PayHip. The ebook offers significant enhancements over the original print version, including: 1) embedded videos that share further insights from the perspective of citizens, professionals, policymakers and researchers; 2) a glossary that provides definitions of important terms the first time they’re introduced in a chapter section or exhibit; 3) easy navigation within and across chapters through hyperlinks and a search feature; and 4) self-tests (with pop-up answers) for those who want to ensure they understood key points.

We’re pleased to offer the ebook at the same price as the original print version, which helps to cover a fraction of our costs. In order to help protect the University’s copyright, the purchaser’s email and PayPal account number will appear on every page of the ebook (this is a text stamp and will not provide access to your PayPal account).

Please note that you need Adobe Reader installed on your device to open the ebook, which is in PDF format.

Free chapters

McMaster University is also continuing to make individual book chapters (except for the introduction and conclusion) freely available to advance the public interest. However, the University does not give permission for these chapters to be posted on websites other than the website of the McMaster Health Forum, or to be circulated electronically.

Chapters include figures that highlight key features of a sector or other parts of the health system ‘at-a-glance.’ Given the complexity of these figures, they are spread over two pages. We offer two different formats of each chapter for download, the second of which allows for the two-page ‘at-a-glance’ figures to appear on facing pages. 

Ontario’s Health System: Key Insights for Engaged Citizens, Professionals and Policymakers
Copyright © 2016 McMaster University. All rights reserved.


Chapter sections

(1 page-per-sheet)

(2 pages-per-sheet)


Available in the print version only

Introduction and overview
(Chapter 1)

Historical context | Geographic and socio-demographic context | Political context | Economic context | Health status of the population | Overview of the book



Building blocks of the system

Governance arrangements
(Chapter 2)

Policy authority | Organizational authority | Commercial authority | Professional authority | Citizen and stakeholder involvement



Financial arrangements
(Chapter 3)

Financing the system | Funding organizations | Remunerating providers | Purchasing products and services | Incentivizing consumers



Delivery arrangements 1: Infrastructure
(Chapter 4)

Infrastructure – Places where care is provided | Infrastructure – Supports for care | Capacity planning | Capital spending



Delivery arrangements 2: Workforce
(Chapter 5)

Health workforce supply, density and distribution | Regulated health professionals | Unregulated health workers | Planning, education and training, and other policy levers



Using the building blocks to provide care

Care by sector
(Chapter 6)

Home and community care | Primary care | Specialty care | Rehabilitation care | Long-term care | Public health



Care for select conditions
(Chapter 7)

Mental health and addictions | Work-related injuries and diseases | Cancer | End of life



Care using select treatments
(Chapter 8)

Prescription and over-the-counter drugs | Complementary and alternative therapies | Dental services



Care for Indigenous peoples
(Chapter 9)

Context | Governance, financial and delivery arrangements | Programs and services | Places and people



Change and progress

(Chapter 10)

Recent reforms | Proposed reforms



(Chapter 11)

Stated goals of the health system | Improving the patient experience of care | Improving population health | Keeping per capita costs manageable




Available in the print version only

Please note that you need Adobe Reader installed on your device to open individual book chapters, which are in PDF format.

We welcome corrections, updates and feedback, as well as suggestions for conditions, treatments and populations that we do not cover in the book, so that we can incorporate them when we create an eBook and when we update the print version of the book (which we plan to do periodically). Please send your comments to

The appropriate citation for this book is: Lavis JN (editor), Ontario’s health system: Key insights for engaged citizens, professionals and policymakers. Hamilton: McMaster Health Forum; 2016.

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