Is Two-Tier Health Care the Future?

Is Two-Tier Health Care the Future?, is the best book in years about the past, present and future of Canadian Medicare. The book, with its compelling introduction by Colleen Flood and Bryan Thomas, is well written and well edited. Unlike many edited volumes, authors have written coherent, linked, chapters on the most controversial topics in Canadian medical care. These prominently include the history of intense disputes over private and public finance of hospitals and physicians, and address how and why private finance of Canadian medical care has always been and will continue to be so controversial. The most unusual feature of Canadian health care policy—illuminated by chapters on medical finance in other rich democracies—is how judicial decision making in Medicare’s past and present has become dominated by constitutional law and disputes about how much market allocation is tolerable in an egalitarian program like Canada’s Medicare. How that came to be over the past few decades and what the BC Cambie Clinic case means for the future is what this serious work of scholarship provides. -- Theodore R. Marmor

The Canadian health care system is a source of our collective pride, but it is also in serious need of improvement. So often privatization is put forward as a solution to our challenges, with little regard for the evidence. This excellent collection offers evidence and analysis from some of our greatest thinkers on a wide variety of issues relating to 2-tier health care. A must-read for those who care about protecting and enhancing the national treasure that is Canadian Medicare.

Danielle Martin, MD