Medicare, Health Profession Regulation and the State in 1970s Canada

Tracey Adams, Western University

This paper argues that the implementation of Medicare in Canada, and associated changes in the health care system, combined with 1960s social change to prompt a questioning of prevailing systems of health professional regulation in several Canadian provinces. Most notably, the provinces of Quebec, Ontario, Alberta, and British Columbia established committees and commissions to review healthcare provision and professional regulation in the late 1960s and early 1970s. These bodies reached strikingly similar conclusions, arguing that the prevailing system of professional regulation would no longer suffice and recommending significant policy changes. Despite these similarities, policy outcomes across the four provinces differed widely. Quebec completely transformed its system of professional regulation in 1973, while Ontario considered sweeping change, before implementing meaningful but more modest changes in 1974. Alberta established a new framework for regulating lower-status health occupations in 1980, while British Columbia made no meaningful change in the era. Informed by ecological theories and other research, this paper examines why policy directions differed so substantially when the problems and solutions identified by health policy advisers were so similar. It highlights the significance of state-profession relations, anti-medicine sentiment, and politics and political cultures to the regulation of health professions in the late twentieth-century. In so doing, it sheds light on the factors that shape health regulatory outcomes in Canada (and beyond), including state-profession relations, politics, and the changing role of expertise.

No extended abstract or paper available

 Presented in Session 196. Disparities in health care