ABSTRACT
Canada has a unique history in the development of health policy and has attracted a wide interest from a range of commentators. These include seminal historical studies by Evans (1984), Taylor (1987), and Naylor (1992); and comparative contributions from Gray (1991), Drache and Sullivan (1999), and Tuohy (1999). The federal state role in the national health plan in Canada has been a pivotal one of conditioning provincial behavior through cost-sharing and a constitutionally acknowledged social spending power, notwithstanding clear provincial jurisdiction for health care. In Figure 7.1, we have characterized the national health care plan in Canada through five periods, differentiated by the manner in which changing patterns of state activism (expressed through federal-provincial transfer payments) have altered the scope of national health insurance and thereby the behavior of key actors in the delivery system.
