The three dimensions of universal Medicare in Canada

The history of C anadian Medicare is reviewed to demonstrate the extent to which non‐universal alternatives almost became the norm in C anada. While this historical survey focuses on the most critical dimension of universal coverage – the drive to have all C anadians insured on the same terms and conditions – it also addresses the second and third dimensions of universality, the extent of user fees and the breadth of coverage, respectively. However, that there is no single national narrative on health coverage, in part because of the highly decentralized nature of the C anadian health system. Ultimately, public‐sector health system coverage is a policy decision taken at the sub‐national level by the provincial rather than the federal government.