In Steps on the Road to Medicare Stuart Houston shows that Saskatchewan has led in the development of publicly funded health care since 1915. Among Saskatchewan's many firsts were the payment of municipal doctors, the development of municipal hospitals, and advances in the treatment and prevention of tuberculosis - then the leading cause of death - that culminated in January 1929 with universal free diagnosis and treatment of TB. Given this background of leadership, it was logical for North America's first social democratic government, the CCF, led by Tommy Douglas, to go further, beginning with medical care for pensioners and widows. This was quickly followed by a universal, comprehensive health care plan, instituted in the Swift Current region in July 1945, two years before Britain began such a program. Universal, province-wide hospitalization insurance was put in place in January 1946. Advances in psychiatry consisted of the first inclusion of psychotic patients in an open psychiatric ward in a general teaching hospital in 1955, while cancer firsts included the first government-sponsored cancer clinics, the first full-time cancer physicist, and the world's first use of calibrated betatron and cobalt-60 machines for treating cancer. Why was Saskatchewan so consistently first in health care? Houston argues that not only was the population both altruistic and ingenious with a well-developed spirit of co-operation but that its leaders, including Maurice Seymour, R.G. Ferguson, Harold Johns, and Tommy Douglas, showed unusual foresight. He details how from 1915 through 1962 government responded quickly to public need and suggests that it should be equally responsive today.

"Steps on the Road to Medicare is a major achievement. It pulls together the history of the development of medicare in Saskatchewan and demonstrates the spirit of innovation that Canada will need to save it." Allan Blakeney, former premier of Saskatchewan, and scholar-in-residence, College of Law, University of Saskatchewan