In response to Sam's call for published information on the 1984 Canada Health Act, may I suggest that that information is something that could usefully be posted to the entire list, rather than Sam's private mailbox alone? I have some references which I use in teaching a unit on health care systems, and I would love to see what others are using. Furthermore, in this era of economic restructuring leading to reassement of health care models, reflecting on the debates and political lobbies which precluded the establishment of a Canadian Health Care model is probably a useful and informative exercise. For example: Swartz, Donald 1993 The Politics of Reform: Public Health Insurance in Canada. *International JOurnal of Health Services* 23(2);219-238. Swartz says "the centerpiece of Canadian health policy is a system of public health insurance covering the cost of hospital and medical services for all Canadians". He "analyzes the historical development of this policy and critically assesses its structure and dynamics". This is why I reccomend Swartz' article. It provides a neat, concise history which relates the introduction of health insurance policy to the actions of Canadian workers and the "protracted industrial and political struggle" over labour controls and votes. I think that as our society undergoes another protracted stuggle over controls on labour, we should recognise the current attack on health care policy as a part of a longer historical structure. For cross cultural comparison, including a quick reminder that in fact Canada was not the first nation to institute socialised Health Care policies, and for a sense of deja vu, see: Scarpaci, Joseph L. 1987 HMO Promotion and the Privatisation of Health Care in Chile. *Journal of Health, Politics, Policy and Law* 12(3);328-344. and: Haignere, Clara S. 1983 The Application of the Free-Market Economic Model in Chile and the Effects of the Population's Health Status. *Inter. J. of Health Services* 13(3);389-405. The former article outlines the introduction of a form of health insurance for some (railway) workers in Chile, in 1918. Both discuss and document the destruction of the health care system and the resulting decline in polulation health after the forced economic restructuring of the early 80's, carried out under the guise of "free-market reforms". Ironically, as Haignere documents, the government was forced to introduce maternal-child nutritional suppliment programs because, as people's real incomes dropped and economic disparity precluded access to safe, clean housing and nutrition, the infant and maternal morbidity and mortality rates began to CLIMB (as Stats Canada has noted in the past year for us), a most unusal statistical event in peace time, according to the WHO. I can't help but note the similarities between Chile in the mid 80's and many of the Canadian provinces in the 90's. Those in Eastern Europe and South America, thinking to structure Health Care should recognise the speed at which unfettered free-market policy (a la Chicago School of Economics) destroys population health (among other things), as much as it claims to make it possible, as John Ralston Saul demonstrates in his latest book *The Unconscious Civilization* (1995). Heather Young Leslie Midwifery Education Programme @ McMaster University Phone:(905)521-6015 Fontbonne Building, Suite F622, 50 Charlton Ave E. Fax:(905)521-6014 Hamilton, Ontario, Canada L8N 4A6 <><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><<><>><><<><> Fakaanga 'i tefito'i niu It's easy to criticise from the shade ><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><>