Private Practice, Public Payment: Canadian Medicine and the Politics of Health Insurance, 1911-1966
Description
Contains Illustrations, Bibliography, Index
$35.00
ISBN 0-7735-0557-1
Author
Publisher
Year
Contributor
Paul G. Thomas is a political science professor at the University of
Manitoba and the co-author of Canadian Public Administration:
Problematical Perspectives.
Review
David Naylor, who is a physician and a medical historian, has written an interesting and detailed account of the role of the medical profession as a pressure group from 1911, when state health insurance first became an issue, to the enactment of the Medical Care Act in 1966. Developments at both the national and at the provincial levels are described. It is interesting to learn, in light of recent clashes between medical associations and governments, that organized medicine at times took a positive view of state-administered health insurance. The overriding priorities of the profession were, first, to preserve arrangements in which physicians were self-employed providers of medical services on a fee-for-service basis and, second, to avoid entry into a direct bargaining relationship with government, not purely to protect incomes but also in order to prevent meddling in their practices. Significantly, Naylor concludes that medicare has had little direct impact on the freedom of physicians to practice, although many of his colleagues would disagree with this judgement. While this book is written primarily for an academic audience, many other readers will find it intriguing to read about salaried municipal doctor schemes early in this century, the doctors’ strike which took place in Winnipeg in 1933, the fight over the British Columbia health insurance act of 1936, the medicare dispute in Saskatchewan in
1962, and the origins of the national medicare program (1967). Naylor puts current controversies in historical perspective which is a valuable contribution.