How Medicare Began By Ed Finn

Once there was a government that stood up to business, the media and the medical establishment. The result was Medicare. The current attacks on Medicare are not being led by the doctors, but are now being directed by the huge multinational private health care corporations that stand to reap billions in profits from a two-tier system, as they do in the United States.

As a witness to the birth of Medicare in Canada and as someone who played a small part in bringing it to life during the stormy summer of 1962 in

Saskatchewan, I am sickened now by the spectacle of its slow death by strangulation.

Public health care did not have an easy birth. It was fiercely opposed by the medical, business and media élites, who saw it as a threat to their profits and privileged status. They lost the propaganda battle 38 years ago, but now at last they have managed to drag "socialized medicine" down and like vultures are pecking greedily at its entrails.

Medicare in Canada had its inception in the mind of Tommy Douglas. When he was a boy, he fell and hurt his knee, and a bone disease (osteomyelitis) set in. His parents couldn’t afford the services of a bone specialist, so he was put in a Winnipeg hospital as a cherity patient. The doctors decided that they had no choice but to amputate his leg. But he was lucky. A orthopedic surgeon was looking for patients he could use in his teaching classes, and after examining Tommy’s swolen knee, he told his parents he could save the leg if they would let him use the boy to help teach his students. Of course they gladly agreed, and Tommy escaped the planned amputation.

"Had I been a rich man’s son instead of the son of an iron molder," he later recalled, " I would have had the services of the finest surgeon, and would not have had to depend on chance for a cure. All my adult life I dreamed of the day when an experience like mine would be impossible and we would have in Canada a program of complete medical care without a price tag."

He took that dream with him into the Saskatchewan legislature when he first became premier in 1944. But, although some important steps toward that goal were taken fairly soon, including a province-wide public hospital insurance plan in 1947, it was not until Nov. 17, 1961 that the CCF government felt confident enough to pass the full-fledged Saskatchewan Medical Care Insurance Act.

By then, Tommy Douglas had left provincial

politics to become national leader of the New Democratic Party in 1961. But he had fought the 1960 election in Saskatchewan on the central promise of introducing Medicare, had shepherded the bill through its early stages, and felt safe in leaving its final implementation to his successor as premier, Woodrow Lloyd.

The passage of the act ignited a firestorm of controversy and conflict that raged for months leading up to its planned starting date on July 1, 1962. And when that date arrived, it triggered a province-wide doctors’ strike and a summer-long battle that raged even more furiously.

I was plunged into the thick of that dispute shortly after it erupted when the Saskatchewan Federation of Labour sought my help as a writer and editor. The unions and other supporters of the legislation faced an onslaught of anti-Medicare propaganda launched by the doctors, the major business groups, and nearly all the newspapers and radio stations in the province.

The doctors had succeeded in scaring and enraging many of their patients, warning them in personal letters that Medicare would deny them the right to choose their physicians and would destroy the important doctor-patient relationship. Patients who believed these lies started forming "Keep Our Doctors" Committees (KOD). Support for the K.O.D., fed by mass anxiety, came from the opposition Liberal and Tory parties, from business people, some clergymen, and from anyone with a grievance against the government. Behind the scenes, the powerful Canadian and American Medical Associations put their resources at the disposal of the Medicare foes.

It was a one-sided public relations contest, but we managed to get the facts out to many residents, using the few media outlets that would accept our press release, and by starting our own weekly newspaper, The Public Voice. This paper was widely distributed door - to - door by the many Citizens for Medical Care Committees that sprang up to oppose the K.O.D. Committees. As the war of words continued, we did some polling that revealed, the anti-Medicare forces weren’t holding onto nearly as much public support as they claimed.

The doctors and their more fanatical backers turned out to be their own worst enemies. Their

attacks on the bill, on Premier Lloyd, and on the few doctors who continued to provide services grew more wild and hysterical. Their posters that caricatured CCF leaders as Nazis and communists, and their burning of effigies of Tommy Douglas, disgusted many more people than they pleased.

The turning point in the struggle came in mid-July, when the doctors and their K.O.D. allies staged what they boasted would be a massive public protest in front of the Legislative building in Regina. They predicted a turnout of a least 20,000, but barely 4,000 showed up on a warm sunny day.

The failure of this widely promoted rally broke the doctors’ defiance. They had overestimated their public support and underestimated the grassroots sentiment in favour of a public health care plan. Their strike was called off after 23 days and a settlement was reached shortly afterwards with the help of Lord Taylor from Britain, who acted as a mediator. Medicare was soon solidly established in a Canadian province, providing a model that was extended across the nation with the adoption of the Canada Health Act in 1967.

Tommy Douglas’s dream had become a reality.

My mind keeps returning to that historic summer in Saskatchewan as I see the precious legacy of a great Canadian leader now being torn to shreds. Every night during that fateful summer, we who brought Tommy’s vision to the public met to share our concerns. We all wondered if the CCF government, would have the courage to keep defending its Medicare bill. It wasn’t easy. The enormous corporate and media pressure brought to bear on Lloyd and his cabinet was truly awesome. It continues to astonish me that they remained resolute day after punishing day. Certainly, no government today would display such fortitude.

It’s ironic that the current attacks on Medicare are not being led by the doctors, who have largely been converted to its benefits. In fact, the Canadian Medical Association in 1998 enshrined Tommy Douglas in its Hall of Fame, the only non-physician to be so honoured. His plaque proudly identifies him as "the Father of Medicare."

The attacks are now being directed instead by the huge private health corporations that stand to reap billions in profits from a two-tier system, as they do in the United States.

The politicians who now serve these corporate interests are committed to dismantling Medicare. They include most provincial premiers and health ministers and - despite their public disavowals - the Chrétien Liberals. (Why else would Health Canada give its written permission to Ralph Klein to allow doctors in Alberta to practice in both public hospitals and private clinic? Without that approval from Ottawa, Klein would not have dared introduce

his Bill 11 to privatize some of the province’s hospitals.)

Medicare is dying in Canada because our corporate rulers want all of its potentially profitable operations privatized. And what they want these days, they get. Klein may well lose the next election in Alberta, but that’s a price he’s willing to pay to please his business bosses. He knows they’ll reward him generously for defying public opinion and abandoning the public interest on their behalf.

It may not be much longer before a boy in a poor Canadian family who falls and hurts his knee may have his leg amputated instead of repaired. There’s no profit to be made from operating on kids whose parents can’t afford expensive treatment.

How the Federal Government Helped Alberta Privatize Its Health Care

While Prime Minister Chrétien and Health Minister Allan Rock publicly condemn Alberta Premier Ralph Klein for his plans to promote private health clinics in that province, they privately gave their approval for Alberta doctors to work in both public and private clinics at the same time.

Documents obtained under the Access in Information Act included a memo by an official of the Alberta Health Department, Robyn Blackadar, praising the feral government for reversing its policy that doctors wishing to enter private practice had to opt out of Medicare.

Ottawa’s policy reversal was crucial in permitting Alberta to proceed with its policy of expanding private clinics.

"Without Health Canada’s agreement on the principle that it is acceptable for physicians to work in both the public and private sectors." Blackadar’s memo states, "the existing private policy would have been impossible to implement."

Health Care, Texas-style

Since George W. Bush became governor of Texas in 1995, he has not made health care a priority, nor has he ever made a speech on the subject. Instead, his administration opposed a Patient’s Bill of Rights in 1995 before grudgingly accepting one in 1997, and fought unsuccessfully to limit access to the new federal Children’s Health Insurance Program in1999.

This despite the fact that Texas has had one of the worst public health records among the American states for many decades. More than a quarter of its residents have no health insurance. Its Mexican border is a hotbed of contagious disease. Texas ranks near the top in the nation in its rate of AIDS, diabetes, tuberculosis and teenage pregnancies, and near the bottom in immunization, mammograms, and access to physicians.

Bush has not tried to tackle any of these major health problems, even with a large state budget surplus.