| 1. | Consumer involvement in decision making about social care |
| 2. | Canada's commitment to the welfare state or its replacement, the welfare society |
| 3. | The effectiveness of the present organization for delivering collectivist health care to Canadians and the prospects of improving it through regionalization |
As a result of experiences arising out of the Great Depression of the 1930s and wartime experiences of the 1940s, Canada decided to follow other western developed countries and set up a welfare state organization to promote full employment and provide social supports for those who needed social care. But in 1945-46 efforts to introduce new programs of federal grant aid to enable the provincial governments to set up better service delivery schemes were thwarted, at first, by two provinces which raised constitutional objections to the federal government involvement in social affairs. These objections were ultimately overcome, but there were long delays in implementing federal plans and the Canadian welfare state was not in place until the end of the 1960s.
In the meantime the Province of Saskatchewan led the others in developing a plan for providing a provincial level of collectivist health care. Other English-speaking provincial governments were not so far ahead in their thinking as Saskatchewan, but they could see electoral advantages in supporting welfare state approaches. After Ontario's resistance to federal intervention was removed in 1957, the provinces were able to claim open-ended matching grants and to set up a wide range of social programs. Quebec made a separate deal with the federal government in 1963 which enabled that province to claim grant aid on its own terms.
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