Canadian Health Care: The Journey from Medicare to Universal Health Care

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“Medicare is a Canadian success story. Not perfect, but good enough to be envied by much of the world.” — H.L. Mencken. Canadians embrace their public healthcare system more passionately than any other public program. In Ontario the government spends $254 billion with that being about 11% of Canada’s GDP. Universal health care is an extension of Canada’s identity. When you ask someone about what they know or think about Canada, universal health care usually comes to mind. The current Canadian healthcare system is still strongly influenced by its foundational legislative history and Canada’s federal structure of government. With its responsibilities for governance divided between the federal and provincial/territorial governments, Canada is unique. Many of the roles and responsibilities for canada’s healthcare system are shared between the federal and provincial/territorial governments. The federal government provides funding for the provincial governments. In 1867, the Constitution Act clearly directed that healthcare, as well as other social programs, be administered by the provinces rather than the federal government. Each province and territory now has their own name for their system. This act continues to influence how the Canadian healthcare system works over 125 years later. By exploring the importance of Tommy Douglas, the history of Canadian healthcare, and it’s economic impact/flow of money we can see how having the provincial government take over healthcare helps to show Canada’s strength of diversity.

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In Canada before 1962, especially during the war The father of Canadian Universal Health Care,Tommy Douglas has been the subject of controversy in the past being labeled a communist by political opponents because he believed in communist values and being called a ‘red’ by political opponents. During 1948 many extremist parties including the Social Credit and the Co-operative Commonwealth Federation (CCF), in which Tommy Douglas was the leader refused to renounce their efforts. Tommy and many other members of the CCF displayed Nazi tendencies. His controversy stemmed from his ideology of providing free quality healthcare to all Canadians especially during the doctors’ strike of 1961, no matter their economic or social situation. Born in Scotland, he was six years old when him and his family immigrated to Canada, many people did not appreciate his work as they did not see him as a “true Canadian”. His family ended up in Winnipeg which at the time Manitoba had only joined Canada five years prior. In 1919 when he witnesses the Winnipeg General Strike. Tommy’s interest in healthcare began soon after birth when he was diagnosed with pneumonia, Osteomyelitis a bone infection and several other alimmets. Doctors were brought into the home where they proceeded to cut open his legs on the family's kitchen table. He was sedated with chloroform and left in a coma. This treatment did however save Tommy’s life and planted the seed for his vision: universally accessible health care. Him and many other professionals also looked to Britain for inspiration. Not only did Tommy look to Britian for inspiration but also, the United States of America. The United States had a private system where there was little to no funding for the elderly and the poor. Canadians agreed that looking to the United States proved to be useless as they did not have the same morals as Canada itself. Douglas served as the Premier of Saskatchewan from 1944 to 1961 and Leader of the New Democratic Party from 1961 to 1971. In 1935 he was elected into the House of Commons with the CCF party, while he was a baptist minister. Douglas’ cabinet was the first social democrat government in North America and it introduced the continent's first universal health care program, run by taxes. Many people then and today consider, Tommy Douglas the ‘Father of Medicare’ in Canada.

Canada’s first hospitals including the Ottawa General Hospital opened on March 3rd, 1665, where a contract in what is now Montreal was signed. Later in 1710 apothecaries and barber surgeons convince the governor to forbid practise by anyone who has not been in New France for a long time. In 1759, when the British ruled over New France they had little to no regard of practising French barber surgeons. Prior to 1962, especially during war times getting medical help was not only hard to come by, but were exceedingly unsanitary. Many of the makeshift hospitals were made up of tent like structures within the field. With women working as nurses and attendants. Inspections that were done around this time in developed countries began to understand the poor state of health within the population. Douglas and other health care advocates were inspired by the United Kingdom’s beveridge report of 1942, which excited canadians who wanted a post war welfare state. On July 23rd, 1962, Tommy Douglas along with a few CCF party representatives and the Saskatchewan College of Physicians and Surgeons signed what the “Saskatoon Agreement” During the late 1950’s the Canada Health Act was founded based on five principles of; universality, accessibility, comprehensiveness, portability, and public administration. Earlier on Douglas outlined five principles that would provide the foundation for provincial funding: prepayment, universal coverage, high quality of service, public administration and a plan that was “acceptable both to those providing the service and those receiving it.”. Which were later used to create the now five principles.

To assist in the regulation of the Health Act, In 1867 the Canadian Medical Association created a code of ethics and values devoted towards the improvement of Medicare and safety of the doctors and the patients. Today many different hospitals and medical treatment centres must follow codes to ensure safety of themselves and their patients. Later on after the codes were introduced by the Canadian Medical Association, they would soon be altered throughout the years to fit the ever changing times. Free health care has never actually been free. Back in 1883, coal miners from Glace Bay, Nova Scotia decided that they wanted to have deductions from their pay in exchange for insurance against hospitalization costs. On January 1st 1947 the first public insurance bill was introduced. It wasn't until nineteen years later when the Medical Act of 1966 was introduced. This bill allowed for the extension of health insuramce to cover for doctors’ services. The Canadian health care system is unique in that it prohibits the private health insurance coverage for the fundamental services that are provided by the Canada Health Act; private insurance can be used as a supplement for services that are either partially covered or not yet covered under the universal health insurance. In 2012, Ottawa only provides around 17% of the public spending on health care, while the rest is subsidized by the provinces. In Canada the system that is now used is the single payer system. where basic services are provided by private doctors, with the entire fee paid for by the government at the same rate. Most government funding (94%) comes from the provincial level. In Canada’s system pharmaceuticals provided outside of hospitals.

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