Medicare in Canada is not only this country's most treasured social programme, it has become a defining national characteristic. Even with recent concerns over flaws in the system - long waiting times, shortages of key service providers - leading to questions about the possible benefits of a two-tiered approach, the consensus is that single-payer, publicly funded health care has worked for forty years to provide Canadians with accessible, high quality services at a much lower cost than in the mainly for-profit system in the US. In "Health Insurance and Canadian Public Policy", Malcolm Taylor describes the emergence of Medicare, providing an interesting window into current health care debates. He discusses the seemingly endless series of federal-provincial exchanges and negotiations involving issues of jurisdiction, cost allocations, revenue transfers, and taxing authorities as well as efforts to accommodate opposition from various special interests that would eventually evolve into a system that provided access to adequate health care for all Canadians on the basis of need, irrespective of financial circumstances.
Long considered the definitive study of Medicare in Canada, "Health Insurance and Canadian Public Policy" clearly identifies the crucial contribution of political courage and leadership in achieving a single-payer, publicly funded system. A new introduction by Allan Maslove discusses the book's relevance to contemporary debates and drives home two important themes - that conflicts between federal and provincial governments are not new and that, in spite of opposition from various organized interests, strong popular support for Medicare insured that the initial project was not derailed.