Historians Discuss the Development of the American Healthcare System

27 10 2009

I thought I would share these two links related to the history of healthcare in the United States.

This podcast explores “the origins of the health care debate, and try to explain how we wound up with a system so different from the European model.”

James Mohr, history professor at the University of Oregon, places the current healthcare debate in a historical context. He explains, “We have to find ways to combine what is positive and unique about our system while eliminating the historical anomalies that make it unsustainable.”


Toronto General Hospital

I will add that the history of Medicare in Canada is one of the great under-researched topics in 20th century Canadian history. Medicare is clearly an important institution for the Canadian identity. Tommy Douglas was voted the greatest Canadian because of his role in creating our current system. More importantly, Medicare has a big impact on the level of health in Canada. Health spending represents a big share of GDP. Health care is consistently one of the most important issues for Canadians, according to pollsters. But while the general public is very interested in Medicare, academic historians, it appears, are not. There are few books on the history of Medicare. Steps on the Road to Medicare: Why Saskatchewan Led the Way by Sylvia O. Fedoruk and Stuart Houston is one of the few good books on this topic. Moreover, it deals with only one province and was written by two people who are not professional historians. Stuart Houston is a medical doctor. I base my annual lecture on the evolution of Medicare on research by non-historians: Eugene Vayda, Raisa B. Deber, “The Canadian Health-Care System: A Developmental Overview” in Canadian health care and the state : a century of evolution,  edited by C. David Naylor (Montreal : McGill-Queen’s University Press, 1992).

There is an active community of historians of medicine in Canada. For instance, Michael Bliss has published a biography of Sir Frederic Banting, the inventor of insulin, and Jaclyn Duffin at Queen’s has published an interesting history of medicine in the Western world. Shelley McKellar at UWO has published a biography of Canadian surgeon Gordon Murray. However, there are few works on the history of the Canadian healthcare system.

Many of the students in my post-1867 Canadian history course want to write their essays on Medicare. Along with Vimy Ridge, it is the most popular topic. Unfortunately, there are few secondary sources to which I can direct them. (I have done a diligent search). What is a needed is a good book that gives the history of our health care system from say 1900 to the present. The book would talk about the Marsh Report, the developments of the 1950s, the Saskatchewan Doctors’ Strike, Diefenbaker, the Royal Commission on Health Care, Medicare, the Canada Health Act of 1984, the impact of the Charter of Rights, etc. Unfortunately, this book doesn’t exist.

This situation is absurd and represents a big systemic failure on the part of the Canadian historical profession. For some reason, research on the history of health care is not valued.