Canada's health care, which comprises a myriad of institutions and practices, is often referred to as Canada's best-loved social programme. This support is not surprising, given that it has been one of the most accessible health care systems in the world and has played a significant role in prolonging the life of many Canadians. In recent years, however, it has come under attack from a variety of sources. Every jurisdiction in the country has initiated far-ranging reforms aimed at reducing costs and has introduced strategies developed for lean and mead production in the private sector. Continuing cost cutting measures and the resulting dismantling of the country's health care programs have seen a vast number of hospital beds closed, drugs delisted, services privatized, average ages for admission to long-term care facilities raised, fees charged, waiting lists and waiting times extended, and day surgery and out-patient clinics expanded. More responsibility has been shifted to the 'community' and to family members, where women in particular are expected to administer treatments and to provide care without the structures, expertise, and resources they need. Meanwhile, in the labour forces tens of thousands of health-care providers face deteriorating terms and conditions of employment, despite the effects on their health care or on the health of those they serve. Wasting Away examines how many of these reforms fail to address the fundamental problems in the system.

Many of the provincial reports justified cutbacks by agreeing with the critics of the system that the focus should be on health, rather than illness, and that health is determined not only by individual lifestyles but also by social conditions. With such an approach, it could be argued that part of the solution to rising costs is prevention and another part is to send care, in the words of one report, "closer to home". Although there is talk of "client-oriented" care, total quality improvement, employee empowerment and community support, reform has primarily meant less of the same within institutions and more unpaid work for women in the home. The basic problems with institutional care remain largely untouched or even exaggerated while fewer and fewer people have access to good care.