“To know the causes of things ” – rerum cognoscere causas – was the motto that always greeted me when I entered the Old Theatre doors of the London School of Economics and Political Science as a PhD student. For as long as I can remember, I have been curious about what has caused the world we live in and this has led me to always ask why institutions and ideas have evolved in a certain way. Understanding matters from an historical perspective has been essential to me, as natural as breathing air. Reconstructing events from primary sources – especially archival documentation – has preoccupied much of my working life. Although I am more specialized in economic and policy history, I have also done considerable research and writing in environmental and political history. In my view, history is less a subject than a methodology based on the proficient use of primary sources combined with an understanding of context, a respect for the unique and contingent, and a willingness to engage with the unfamiliar.
After conducting over a decade of research into the subject, I am finalizing a book on the history of Canadian medicare. I am also completing my research on the Saskatchewan Children’s Drug Plan which, although dismantled in the mid-1980s, is still perceived as one of the most successful policy interventions in terms of improving the oral health of an entire population. I have also completed an expert brief on the history of medicare as part of litigation which questions the constitutionality of single-payer and single-tier medicare as it has evolved in Canada based on many years of research.
Comparative Health Systems and Policy
In my previous studies on individual health systems (Canada, Saskatchewan, Nunavut), I have always tried to compare the jurisdictional subject to appropriate comparators. I have continued this comparative approach in my historical work on the evolution of universal medicare in Canada. I think it is important to be able to separate those factors which are common across time and place and those factors from those which are historically unique to a specific time and place in order to determine underlying causal relationships and theories. This is most effectively achieved through explicit comparison of similar events (e.g. physician strikes) in different jurisdictions.
I am currently the Canadian representative for a web-based platform on health systems that allows for systematic comparison of key design features and policies. The Health Systems and Policy Monitor (www.hspm.org) is sponsored by the European Observatory on Health Systems and Policies.
In Canada, I have been heavily involved with Pan-Canadian Health Reform Analysis Network and its journal – Health Reform Observer / Observatoire des Réformes de Santé. The purpose of this academic network is to encourage comparative research in Canada and to take advantage of the natural experiments in health policy which often occur in a decentralized federation. I am also the general editor of a provincial and territorial series of health system profiles based on a template similar to the European Observatory’s Health System in Transition (HiT) series.