Universal Vulnerability: Canada's Health Care Reform in Historical Context

The Canadian health care system is regularly understood to be both universal in its access and care, as well as intricately linked to a Canadian 'value' system. As such, policies which suggest changes to the system's structure are not generally perceived to be a threat to its universal and equalizing character. This paper utilizes historical political economy to determine the degree to which the Canadian state is institutionally and structurally inclined to allow market-oriented reforms to proceed in the coming decade. The paper seeks to explain the manner in which the ongoing protection of the Canada Health Act (ensuring universal and equal care across the Provinces) is not merely a function of passing popular politics. Rather, it is important to take note of the historical and institutional legacy of the state, it's long-term involvement in health care, and the likely character of its future policy commitments. Policy makers and patients alike need to pay attention to such historical and structural determinants, as the political reliance on 'values' may not suffice to stem the tide of market-based reform throughout the system.