Private Practice, Public Payment

Naylor's particular concern is with the nature and extent of the medical profession's opposition at both the provincial and federal levels. He details various developments in medical politics and policies, including the dispute over state health insurance plans in British Columbia during the depression, the national health insurance program drafted by the King government, the doctors' strike in Saskatchewan, and the development and eventual governmental rejections of prepayment plans sponsored by organized medicine. The author concludes that physicians regarded medical insurance schemes over which they had little administrative control, or where coverage was not limited to the indigent or to those earning below a modest wage, as threats to professional incomes and autonomy. His analysis of the evolution of the professional perspectives, policies, and pressure group activities suggests that physicians are as likely to act in their own economic and social interest as any other group, and that they oppose legislation that would threaten these interests while supporting laws that strengthen them. Since the Medical Care Act became law, Ottawa has moved to strengthen health care plans in the provinces, and once again the medical profession has resisted. The final chapter in Naylor's book puts these current conflicts in historical perspective by linking them to their political precedents.