For Patients of Moderate Means: A Social History of the Voluntary Public General Hospital in Canada, 1890-1950

The Great Depression, however, finally exhausted the average patient's ability to pay and engendered a national health-care crisis. A public hospital insurance scheme was first achieved in Saskatchewan in 1947 and nationally in 1957. Universal accessibility without fear of the financial consequences of hospitalization reflected concern for both the medical health of Canadians unable to pay for hospital care, and the economic health of the paying 'patient of moderate means' threatened with medical pauperization. It also provided the resources necessary to address the modern epidemic of lifestyle diseases and to accommodate the demands of the post-war therapeutic revolution. Employing the historical records of selected individual hospitals, reports and data from all levels of government, a wide range of professional medical, nursing, hospital, and public health journals, and the international historiography of hospital history, David and Rosemary Gagan describe and account for the invention, rise, decline, and rebirth of the modern Canadian hospital between 1890 and 1950. They pay particular attention to the evolving interdependence of doctors and hospitals in the struggle to legitimate the social and cultural authority of scientific medicine, the evolution of hospital-based nursing, and the experiences of patients.