An Undisciplined Economist: Robert G. Evans on Health Economics, Health Care Policy, and Population Health ed. by Morris L. Barer et al. (review)

It is little wonder that Robert Evans remains so widely read within Canadian health policy scholarship. Not only has he been enormously influential within his own discipline, he is aggressively and explicitly interdisciplinary, transcending the traditional boundaries of economics. Moreover, he is refreshingly witty and accessible, engaging playfully with the English language throughout his work. This volume, which includes contributions from as far back as 1974, effectively showcases these strengths. The book is divided into four thematic sections: economics and economists, healthcare financing, healthcare policy, and population health. While these four themes often overlap (particularly the first three), the prefaces for each provide periodic reminders of the book's purpose as a unified project and lay out what they want the reader to know about Evans's career trajectory.

By their own objectives presented in the foreword, the editors' work is a success; it assembles some of Evans's most influential work in a single volume while also shedding light on his lesser-known contributions. But it also accomplishes another significant feat in providing a window into four decades of health policy debates. The volume could conceivably be assigned as a textbook for a graduate seminar on Canadian healthcare policymaking. In reading this book from start to finish, the reader gets a clear sense of how policy paradigms have evolved or remained stagnant, as well as the role of the public intellectual–a rarity in anglophone Canada–in driving debate.

Many of the arguments are timely despite their age. Evans's mission as public intellectual concerns 'mythbusting' and challenging common wisdom–however, as he repeatedly acknowledges, some myths never do get fully busted. Popular assumptions about the inherent cost of universality and the inevitable crisis of population aging, each discussed by Evans in writings originally from 1987, continue to dominate mainstream Canadian discourse. At times the editors oversell the extent to which Evans's work has changed paradigms; while that is unquestionably true within academia, the misconceptions against which he sets himself remain pervasive among policymakers and the general public. Evans recognises this; for example, in 'User Fees for Health Care: Why a Bad Idea Keeps Coming Back', he explores the coalitions that form around advancing an idea with seemingly obvious deficiencies.

While by its own admission it cannot be taken as a complete collection of Evans's essential contributions (the editors add suggestions for further reading following each section), this volume clearly accomplishes what it set out to do. It is a must-read for any researcher seeking to understand how debates and common wisdom surrounding health policy evolve, and the role of the public intellectual therein.