The Making and Meaning of Hospital Policy in the United States and Canada

Terry Boychuk
A comparative history of the political origins of national health policy


This comparison of American and Canadian health care takes a fresh and analytical approach to the topic by systematically specifying the historical dynamics that gave rise to such radically different systems of health insurance in the first instance. Terry Boychuk takes us beyond the familiar policy discourse focusing on the benefits and costs of universal health insurance to a greater understanding of how these systems developed.

The Making and Meaning of Hospital Policy in the United States and Canada endeavors to account for why Canada adopted national health insurance and why the United States did not. The findings illustrate the historical primacy of hospital politics and policy in the making of national health policy in North America. The study also establishes the first comparative history of hospital development and hospital policy in the United States and Canada from colonial times to the formation of modern social insurance programs.

This book will appeal to those interested in health policy making, social policy, and American and Canadian political history. Its accessible style recommends it for use in undergraduate and graduate courses.

Terry Boychuk is Assistant Professor, Macalester College.

Praise / Awards

  • "Why, unlike all other advanced industrial nations, does the United States remain the sole country without universal health care? . . . [This book] provides the most careful, incisive, and insightful analysis to date of this question. . . . This is a very important book. . . . This is an exceedingly fine piece of work. . . . Indeed this is a must read for all medical sociologists, healthcare researchers, and policy analysts, as well as for any students of institutional structures who wish to understand how we arrived at and remain mired in our current political and organizational healthcare quagmires."
    —Allen W. Immersion, Florida State University, Contemporary Sociology, Volume 30, No. 2
  • ". . . one cannot but welcome and enjoy the arguments and evidence presented in this book. Boychuk offers the reader, whether a health policy specialist, sociologist, or political scientist, a rich and engaging historical narrative, sustained by ample documentation and secondary sources. To his great credit, he presents the development of hospital policy in the United States and Canada in terms of constantly evolving historical dynamics. In doing so, he sheds fresh light on the familiar puzzle of why Canada embarked on the path to universal health insurance, while in the United States national health insurance remains an elusive policy objective."
    —Antonia Maioni, McGill University, Journal of Health Politics, Policy and Law, June 2001

Product Details

  • 6 x 9.
  • 200pp.
  • 16 tables.
Available for sale worldwide

  • Hardcover
  • 1999
  • Available
  • 978-0-472-10928-9

Add to Cart
  • $84.95 U.S.