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Health resource distribution in Canada has been criticized for being opaque and increasingly inequitable, with its disproportionate emphasis on curative over preventive care. Yet there has been relatively little scrutiny of priority-setting in publicly funded health care in Canada from bodies monitoring the international human right to health. Recently, however, domestic health governance on the one hand, and international health and human rights on the other, have converged around the promotion of evidence-based policy, accountability, transparency and participation as drivers of more equitable distribution of health care resources. This paper tracks the paths toward this convergence. The emphasis in health policy was largely driven by cost containment and service integration concerns, while democratic and institutional concerns around socio-economic rights protection are at the root of the health and human rights shift toward proceduralist approaches. This shared emphasis nonetheless opens new terrains of struggle for human rights approaches to health care distribution in Canada, around (i) managing indeterminacy in social determinants of health; (ii) addressing power imbalances that shape how health information is produced, communicated, and acted upon and (iii) the role of fundamental normative values that limit substantive policy around health. La distribution des ressources en sante au Canada a ete critiquee en raison de son caractere opaque et de plus en plus inequitable, et de l’importance disproportionnee accordee aux soins curatifs par rapport aux mesures preventives. De plus, relativement peu d’etudes concernant les priorites etablies en matiere de services de sante publics au Canada ont ete faites par des organismes de controle du droit, reconnu dans des instruments internationaux, de tout etre humain a la sante. Cela dit, recemment, la gouvernance nationale de la sante, d’une part, et le droit a la sante et les droits de la personne au niveau international, d’autre part, ont converge et mis l’accent sur la necessite de promouvoir des politiques fondees sur des donnees probantes, la responsabilisation, la transparence et la participation, facteurs qui sont aptes a assurer une distribution plus equitable des ressources en sante. Le document suit le cheminement vers cette convergence. Les politiques en matiere de sante etaient largement fondees sur des preoccupations liees a la limitation des couts et a l’integration des services, alors que les preoccupations democratiques et institutionnelles a l’egard de la protection des droits socio-economiques sont a l’origine du virage du droit a la sante et des droits de la personne vers des approches proceduralistes. Ces priorites communes ouvrent neanmoins la porte a de nouvelles luttes visant des approches axees sur les droits de la personne en ce qui a trait a la distribution des services de sante au Canada, luttes qui impliqueront les actions suivantes : (i) gerer l’indetermination dans les determinants sociaux de la sante; (ii) corriger les desequilibres de pouvoir qui determinent la facon dont l’information en matiere de sante est produite et communiquee et les reactions qu’elle entraine, et (iii) eclaircir le role des valeurs normatives fondamentales qui limitent les politiques de fond en matiere de sante.

(2012) 30 Windsor Y B Access Just 247 SO LONG AS YOU HAVE YOUR HEALTH: HEALTH CARE DISTRIBUTION IN CANADA AND PROCEDURALIST HUMAN RIGHTS