Reports of crisis in the cost and provision of health care have been associated with the idea of national health insurance in Canada since its inception. Certainly, Canadians have often been warned there are overworked and underpaid health care providers, shortages of expensive equipment, andlimited hospital facilities, all of which can lead to delays in service, and sometimes fatal consequences for patients. Numerous arguments have been made as to why this situation exists ranging from technological change, consumer ignorance, the monopoly power of health workers, and the specialnature of health care demand. Health Economics and Policy explores the economic realities and illusions of the many problems facing the Canadian health care system and how this has changed over time. It compares expenditures across the provinces and territories and between Canada, the U.S.,Britain, and Australia. Individual chapters explore in detail the financing of medical, hospital, and other institutional care. Structural problems in the organization of services are examined and the implication for policy of numerous factors including privatization schemes, extra-billing,fee-for-services, excessive consumer use, and free trade are studied. Particular attention is devoted to the policy options available to those who manage the health system. In the concluding chapter Professor Brown writes his own prescription for Canada's health care system if it is to continue tobalance patient needs, cost effectiveness, and efficient innovation.

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Malcolm C. Brown, University of Calgary.