This paper considers the impact of a state medical insurance system on the structure of psychiatric services. The tendency of the upper socioeconomic classes to use private practitioners, and the lower classes to use public clinics, is examined before and after the imposition of the medical insurance system in Quebec in 1970. Data from one public clinic reveal a significant rise in the socioeconomic status of patients after Medicare. Alternative interpretations for the change in the clinic population are explored.
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