Children, Politics and Medicare: Experiences in a Canadian Province

Paul G. Thomas is a political science professor at the University of
Manitoba and the co-author of Canadian Public Administration:
Problematical Perspectives.

When people talk of “medicare” they usually mean pre-paid, universal
access to physician and hospital services. This is the individual or
personal side of medicare, but there is also a less well-known
population or community side to Canada’s medicare program. This book
describes 24 such health services provided within the province of
British Columbia. These services include long-term care, ambulance
service, drug and poison information, mental health, dental, maternal
and neonatal programs, and services to the disabled. Based on their
lengthy professional experience in the field and their extensive
research, the authors have succeeded in producing a comprehensive and
detailed account of the development of community medicine in British
Columbia.

The book does not make for absorbing reading, and it is clearly aimed
at practitioners and scholars. The analysis consists mainly of
historical and descriptive accounts of the evolution of legislation,
institutions, and programs. Despite the prominence of “children” in
the title, we do not learn that much about the actual impacts of the
various services on the health of young people; instead, the majority of
child and youth programs are shown to be supplements to existing adult
programs. In addition, the “politics” cited in the title is defined
in this book as “the science of dealing with the form, organization
and administration of the state.” As such, the authors provide little
analysis of the impacts of the wider political process on the
formulation and implementation of the services that constitute “the
unknown side of medicare.” The title of this serious medical history
was apparently chosen for the sake of a few extra sales.