study of the United States’ effects as an economic
and military superpower and the strategies em-
ployed by other nations living in its shadow.
Clarkson, Stephen.Canada and the Reagan Challenge:
Crisis and Adjustment, 1981-85.New updated ed.
Toronto: J. Lorimer, 1985. Another mid-decade
text; details the tensions between the Reagan ad-
ministration and the Trudeau government.
Doran, Charles F., and John H. Sigler, eds.Canada
and the United States: Enduring Friendship, Persistent
Stress. Englewood Cliffs, N.J.: Prentice-Hall, 1985.
Background papers prepared for a meeting of the
American Assembly at Arden House in Harri-
man, New York, from November 15 to 18, 1984.
Details the state of U.S.-Canadian relations at
mid-decade.
Hart, Michael.A Trading Nation: Canadian Trade Pol-
icy from Colonialism to Globalization. Vancouver:
University of British Columbia Press, 2002. Fo-
cused study of the history of Canadian trade and
of the nation’s dependence upon its trade for sur-
vival.
Hillmer, Norman, and J. L. Granatstein.Empire to
Umpire: Canada and the World to the 1990’s.To-
ronto: Copp Clark Longman, 1994. Details the
evolution of Canada’s foreign policy and its ef-
fects upon the foreign relations of other nations
throughout the globe.
McDougall, John N.Drifting Together: The Political Econ-
omy of Canada-US Integration.Peterborough, Ont.:
Broadview, 2006. Studies U.S.-Canadian economic
relations as composing a single, integrated eco-
nomic system.
Stewart, Gordon T.The American Response to Canada
Since 1776. East Lansing: Michigan State Univer-
sity Press, 1992. General history of U.S. foreign
policy toward Canada.
Thompson, John H., and Stephen J. Randall.Can-
ada and the United States: Ambivalent Allies.3ded.
Athens: University of Georgia Press, 2002. Study
of the tensions sometimes hidden and sometimes
apparent within U.S.-Canadian relations.
United States. Embassy (Canada).United States Presi-
dential Addresses to the Canadian Parliament, 1943-
1995. Ottawa, Ont.: Author, 1995. Transcripts of
more than fifty years of presidential addresses to
Canada’s legislature. Demonstrates the evolving
attitudes of U.S. leaders toward their “neighbor
to the north.”
Martin J. Manning
See also Canada Act of 1982; Canada-United States
Free Trade Agreement; Elections in Canada; Foreign
policy of Canada; Foreign policy of the United States;
Mulroney, Brian; National Energy Program (NEP);
Reagan, Ronald; Shamrock Summit; Strategic De-
fense Initiative (SDI); Trudeau, Pierre; Turner, John.Canada Health Act of 1984
Definition Legislation to improve the nationalHealth care in Canada
Date Received royal assent on April 1, 1984
The Canada Health Act established national standards for
health care deliver y, spelling out criteria and conditions
that the nation’s provinces and territories were required to
satisfy in order to receive federal funds.
The Canada Health Act continued a system of public
health care that had its roots in a system established
in Saskatchewan in 1947. Canada’s national system is
public, funded primarily by taxation and adminis-
tered by provincial and territorial governments, but
most of the nation’s health services are provided by
private medical practitioners and facilities. Unlike
the preceding Health Care Acts of 1957 and 1966,
the act of 1984 contained provisions intended to
eliminate direct billing to patients in the form of
extra-billing and user charges.
The act received unanimous support from the
House of Commons and the Senate, and it was given
royal assent on April 1, 1984, thereby becoming law.
The purpose of the legislation was to assure that in-
sured and extended health care services are readily
available to all Canadians regardless of their socio-
economic status. In addition to the provisions re-
garding extra-billing and user charges, the act estab-
lished five criteria for provincial and territorial
systems: public administration, comprehensiveness,
universality, portability, and accessibility. For exam-
ple, it required that health care services of one’s
home province be portable to other provinces and
territories for a period of up to three months. It also
instituted two conditions regarding insured and ex-
tended health care services: Provinces and territo-
ries must file reports with the federal government on
the operation of their health care services, and they
must acknowledge that federal cash transfers are
responsible for the maintenance of their systems. Vi-
olation of the extra-billing and user-charges provi-The Eighties in America Canada Health Act of 1984 181