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During the past decade, the governments of Manitoba and Saskatchewan, like those in other provinces, have introduced major changes to the health care system. This process of health care reform and restructuring has been driven, in part, by federal and provincial policies to limit the role of the state and control public expenditures on health care. Health care reform has also taken place within the context of a public discourse on the determinants of health, which recognizes that health is influenced by social, economic, and environmental conditions, not simply by the delivery of health care services. Several of the reforms in the health care system can be understood as a renegotiation of the boundaries between public and private responsibility for health. The privatization of health care refers to several different policy directions which limit the role of the public sector and define health care as a private responsibility

Privatization in the health care system can be expected to have significant impacts on women as users of health services, as health care workers, as informal caregivers, and as citizens engaged in public debates over the future of the health system. Women in varying circumstances, with access to different resources, will be affected by these changes in different ways. The purpose of this paper is to provide an overview of some of the forms of health care privatization which have taken place in Manitoba and Saskatchewan in recent years, and to begin to identify some of the impacts of those changes on various groups of women.

The impact of health care reform on women has not received the attention it deserves from the research community, although some women have been voicing their concerns about the adverse effects these changes have had on their lives and their health. This situation points to the need for a more thorough assessment of the impacts of health care privatization and other aspects of health care reform on women.