After World War II, the United States and Canada, two countries that were very similar in many ways, struck out on radically divergent paths to public health insurance. Canada developed a universal single-payer system of national health care, while the United States opted for a dual system that combines public health insurance for low-income and senior residents with private, primarily employer-provided health insurance—or no insurance—for everyone else. In National Health Insurance in the United States and Canada, Gerard W. Boychuk probes the historical development of health care in each country, honing in on the most distinctive social and political aspects of each country—the politics of race in the U.S. and territorial politics in Canada, especially the tensions between the national government and the province of Quebec.

In addition to the politics of race and territory, Boychuk sifts through the numerous factors shaping health policy, including national values, political culture and institutions, the power of special interests, and the impact of strategic choices made at critical junctures. Drawing on historical archives, oral histories, and public opinion data, he presents a nuanced and thoughtful analysis of the evolution of the two systems, compares them as they exist today, and reflects on how each is poised to meet the challenges of the future.

More than 50,000 draft-age American men and women migrated to Canada during the Vietnam War, the largest political exodus from the United States since the American Revolution. How are we to understand this migration three decades later? Was their action simply a marginal, highly individualized spin-off of the American antiwar movement, or did it have its own lasting collective meaning?

John Hagan, himself a member of the exodus, searched declassified government files, consulted previously unopened resistance organization archives and contemporary oral histories, and interviewed American war resisters settled in Toronto to learn how they made the momentous decision. Canadian immigration officials at first blocked the entry of some resisters; then, under pressure from Canadian church and civil liberties groups, they fully opened the border, providing these Americans with the legal opportunity to oppose the Vietnam draft and military mobilization while beginning new lives in Canada. It was a turning point for Canada as well, an assertion of sovereignty in its post–World War II relationship with the United States.

Hagan describes the resisters’ absorption through Toronto’s emerging American ghetto in the late 1960s. For these Americans, the move was an intense and transformative experience. While some struggled for a comprehensive amnesty in the United States, others dedicated their lives to engagement with social and political issues in Canada. More than half of the draft and military resisters who fled to Canada thirty years ago remain there today. Most lead successful lives, have lost their sense of Americanness, and overwhelmingly identify themselves as Canadians.