Magazine article Canadian Dimension

The Birth of Medicare: From Saskatchewan's Breakthrough to Canada-Wide Coverage

Magazine article Canadian Dimension

The Birth of Medicare: From Saskatchewan's Breakthrough to Canada-Wide Coverage

Article excerpt

MEDICARE WAS BORN in Saskatchewan on July 1, 1962. It would be the first government-controlled, universal, comprehensive single-payer medical insurance plan in North America. It was a difficult birth. The North American medical establishment and the entire insurance industry were determined to stop Medicare in its tracks. They feared it would become popular and spread, and they were right. Within 10 years all of Canada was covered by a medical insurance system based on the Saskatchewan plan, and no serious politician would openly oppose it.

The same interests that tried to prevent Medicare and are continually trying to destroy it in Canada have mostly succeeded in stopping similar progress in the United States. After more than half a century of struggle, the American Medical Association (AMA) and the private insurance industry still control the US medical system despite minor steps forward like Medicaid for the very poor and Medicare for the elderly. The latest plan passed by Congress and endorsed by the private insurance industry amounts to public subsidies for the insurance industry.

Commentators have often wondered why the campaign for state medicine succeeded in Canada and failed in the United States. The battle for Medicare occurred in the 1960s when our political culture was moving to the left.

Medicare's first breakthrough

It is not surprising that the first breakthrough would be in Saskatchewan. The province, which was the home base of "agrarian socialism," had been governed since 1944 by the Co-operative Commonwealth Federation (CCF) led by T.C. (Tommy) Douglas. The CCF had originally intended to socialize much of the economy but, like social democratic formations elsewhere, had retreated from this position and by the 1950s concentrated on building a welfare state within a mixed economy. Medical care had always been a centerpiece of its welfare state program and by 1959 considerable strides had been made. The initial innovation was universal hospital insurance which was introduced as early as 1947, and by 1958 had been adopted nationally as a federal-provincial jointly funded program. This is what made it financially possible for Douglas to announce in 1959 that the province would be launching a universal medical insurance plan.

Universal state medical insurance was virtually the only major issue in the Saskatchewan provincial election of 1960. The promise of state Medicare was so popular that the opposition parties dared not oppose it outright, but they were distrustful of what they claimed would be CCF-administered "socialized medicine." The organized medical establishment was not nearly so reticent and mounted a ferocious propaganda campaign fronted by the local College of Physicians and Surgeons with the support of the Canadian Medical Association (CMA), the AMA, the local economic elite and most of the media in the province. The College wielded tremendous power and discipline because it was the only economic group representing doctors and was also the licensing body which determined who could practice medicine. Doctors who favoured Medicare were isolated and ostracized by the hierarchy of the profession.

The local medical hierarchy in 1960 took much of their advice from outsiders and adopted tactics which had proved successful in many similar campaigns in the United States. They amassed $100,000 for propaganda purposes, a tremendous sum in 1960 and far more than any party would spend in a Saskatchewan provincial election. Every household received printed propaganda and advertisements flooded the radio and newspapers. Public meetings were held throughout the province and were addressed by prominent doctors and supporters, often under the auspices of local Chambers of Commerce and Boards of Trade.

The crudeness of the propaganda appears to have been based on the assumption that the Saskatchewan electorate was as unsophisticated as their American counterparts. There were denunciations of socialism, communism, "socialized medicine" and the evils of "compulsion. …

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