While almost all universal health coverage in Canada is provided under the Canada Health Act, there is Medicare coverage that is provided outside of the act. This is the first book to explain the nature of these boundary health services, why they exist, and how to navigate them in practice.

The Boundaries of Medicare examines the complex range of public health care services and coverage arrangements that predate or have developed alongside the Canada Health Act. These provisions – including for workers’ compensation, military personnel and veterans, incarcerated persons, migrants, and Indigenous Peoples – are often not well understood, even by those working at policy and delivery levels. Katherine Fierlbeck and Gregory Marchildon aim to improve understanding of these boundary services: why they were established, who is eligible for them, how services are provided, how they are paid for, and how they are managed within a multilevel governance system. They also look at the dramatic increase in virtual health care services since the onset of the COVID-19 pandemic and their relationship to the Canada Health Act.

Explaining the origins, operations, and tensions of government-funded health care outside the Canada Health Act, The Boundaries of Medicare is an essential resource for policymakers, providers, administrators, and patients seeking to navigate Medicare in Canada.

Katherine Fierlbeck is the McCulloch Professor of Political Science at Dalhousie University, with a cross-appointment as professor of Community Health and Epidemiology.

Katherine Fierlbeck's profile page

Gregory P. Marchildon is a Canada Research Chair in Public Policy and Economic History at the Johnson-Shoyama Graduate School of Public Policy, University of Regina. He was executive director of the Royal Commission on the Future of Health Care in Canada (the Romanow Commission). His most recent books include Health Systems in Transition: Canada (2013) and Nunavut: A Health System Profile (2013).

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“An indispensable resource for policy experts, politicians, scholars, educators, and Canadians who want to know more about Medicare, the CHA, and these other systems that provide health-care coverage to Canadians. By focusing on these Medicare-straddling health services, this book invites Canadians to consider how future health-care reforms will affect certain population groups and to envision better ways of extending coverage to everyone who lives and works within Canada’s borders.” H-Sci-Med-Tech

"This descriptive work presents an analysis that can be useful to health planners and related professionals, ... . Recommended. Graduate students, faculty, and professionals." Choice

“Thoroughly exploring the complicated landscape of medical services in Canada, Fierlbeck and Marchildon offer an extremely well-researched, clear, and useful resource to health and medicine scholars and professionals. The Boundaries of Medicare is an enjoyable and unique read.” Catherine Carstairs, University of Guelph and author of The Smile Gap: A History of Oral Health and Social Inequality