Health Systems in Transition: Canada


158 pages
Contains Illustrations, Bibliography
ISBN 0-8020-9400-7
DDC 362.10971




Reviewed by K.V. Nagarajan

K.V. Nagarajan is a professor of economics at Laurentian University.


Based on the template developed by the European Observatory on Health
Systems and Policies, this book juxtaposes Canadian data beside Sweden,
France, Australia, the United Kingdom, and the United States. With the
aid of numerous charts and tables, it manages to summarize an enormous
volume of information in easily digestible form. The format of the book
allows it to be more than just a report card. The strength of the book
is its wide coverage of topics. Its weakness is that the discussions are
sketchy and short. Nevertheless, it is an excellent guide.

The Canadian health-care system is described as an “amalgam of
public, mixed and private systems of health care.” This slim volume
walks us through these systems in terms of their evolution,
organization, financing, and reforms. The author argues that judged by
the objectives of the Canada Health Act, 1984 (CHA), the system has
“performed well.” He also observes that “public health care is not
in crisis.”

There is, however, much room for improvement. Currently, the system is
“deep” (no user fees), but “very narrow” (covers only hospitals
and physicians). While some are arguing for letting the market forces in
for the same coverage, this book makes a completely different
suggestion. The author would like to see post-acute home care, home
mental health care, and palliative care included in CHA as insured
services. He also advocates a national pharmaceutical policy along the
lines of Australia’s Pharmaceutical Benefits Scheme. These suggestions
are worthy of serious consideration as Canada prepares to face the
challenges in health care in the 21st century.


Marchildon, Gregory., “Health Systems in Transition: Canada,” Canadian Book Review Annual Online, accessed June 17, 2024,