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The co-operative spirit of citizens in twentieth-century Saskatchewan nurtured innovation in health care and health policy. 36 Steps on the Road to Medicare showcases the decisions that led to the province's medicare system - the forerunner of Canadian health care. Stuart Houston and Merle Massie document the range of Saskatchewan leadership on Canadian, North American, and world stages: municipal doctors and municipal hospitals, the first Red Cross Outpost Hospital in the British Empire, tuberculosis diagnosis and treatment, a successful pilot comprehensive regional health care plan, government-sponsored cancer clinics, innovative LSD and patient-oriented treatment for psychoses, the first full-time cancer physicist in Canada, and the world's first concerted clinical use of the betatron and Cobalt-60 in cancer treatment. They show how North America's first social-democratic government, the Co-operative Commonwealth Federation - elected in 1944 and led by the incomparable Tommy Douglas - created the blueprint for comprehensive health care and how sequential steps on the road to medicare were implemented quickly and within budget. When federal support for national hospitalization became available, Saskatchewan could afford to initiate medicare in 1962. Other Canadian provinces soon followed Saskatchewan's lead. Updated to engage with current debates, 36 Steps on the Road to Medicare navigates the history of medicare and demonstrates the spirit of innovation that Canada will need to save it.

National health insurance --- Medical policy --- Health care policy --- Health policy --- Medical care --- Medicine and state --- Policy, Medical --- Public health --- Public health policy --- State and medicine --- Science and state --- Social policy --- Health insurance, National --- Insurance --- History --- Government policy

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Medicare has been a crucial part of Canadian identity for nearly fifty years, and it stands in marked contrast to the US health system. But these facts alone do not protect it from dismissive swipes and criticisms, claims that the system is unsustainable, and even proposals to change medicare's fundamentals. In Canadian Medicare, Stephen Duckett and Adrian Peetoom show that the shared values underpinning medicare still provide a sound basis for the system's design. While medicare remains an important pillar of Canadian policy, changes can and must be made. The authors argue for improved primary care to better address increases in chronic diseases, a comprehensive strategy to provide care for the elderly, and the introduction of pharmacare. They demonstrate how, with proper investment, the health of Canadians can be maintained and even enhanced while the nation remains financially responsible. Accessibly written and clearly presented, Canadian Medicare is a call for Canadian citizens to improve on the foundation built by Tommy Douglas and Lester B. Pearson, to become more knowledgeable about their health care, and to let their politicians know that they need to act.

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