Health Insurance in Canada
Morton, Desmond
In the American debate about health insurance, Canada's version (called somewhat confusingly "Medicare" and so referred to in this article) is often cited by supporters and opponents alike....
...fueled by money, Canada's version of socialized medicine has its flaws and failures, but Canadian voters regard their health delivery system as a civic right...
...Although some doctors still hated the system and a few hundred left Saskatchewan, others saw the benefits, and most reported much higher earnings...
...By 1965, the physicianpopulation ratio had actually increased slightly over 1962...
...Despite opposition from some provinces, doctors, and insurance companies, Medicare was adopted in Canada's centennial year, 1967...
...few want free-enterprise medicine again...
...The 1983 Canada Health Act met his few criticisms...
...Justice Hall of Saskatchewan, originally appointed in 1961 by the Conservatives, reported to Lester Pearson's Liberal government that Canada needed and could afford a national medical-care insurance plan...
...In 1962, after years of planning and debate, the same socialist government in Saskatchewan introduced a medical-care insurance plan...
...Look at our last few issues to see if your idea fits in...
...By 1972, all ten provinces had joined...
...And please remember that we can't return articles unless they're accompanied by a stamped, self-addressed envelope...
...Medicare is expensive, but so is the standard of health and hospital care that Canadians expect...
...Backed by the organized medical profession in the rest of Canada and the United States, Saskatchewan doctors offered every imaginable argument against "state medicine...
...The U.S...
...Normally, since the 1920s, Canadians have been mare likely to imitate American institutions than provide their neighbours with persuasive examples...
...But the first real steps were taken in the wheat-belt province of Saskatchewan, where rural communities routinely hired doctors and developed hospitals and other health facilities for local taxpayers...
...Free Trade Agreement (FTA), opponents warned that Medicare might be a casualty...
...In 1980, Mr...
...q To Our Contributors: A few suggestions: (1) Be sure to keep a copy of your manuscript—the mails aren't always reliable...
...belief that health care, from "miracle drugs" to heart transplants, is a product to be sold to the highest bidder could be contagious...
...Precise coverage varies by province, with some offering assistance in the cost of pharmaceuticals, surgical appliances, and home nursing to the elderly and chronically ill...
...3) Type your ms double-spaced, with wide margins...
...Justice Hall's assurances, some Canadians fear that Medicare might vanish as an unacceptable bump on the "level playing field" of North American free trade...
...So would other Canadians...
...Any break in the dam guarantees runaway costs for patients or the community...
...Moving health costs from private to public purses involves U.S...
...Pioneered by the socialist Co-operative Commonwealth Federation (CCF) and its successor, the New Democratic Party, Medicare is based on a plan recommended by a Conservative-appointed royal commission and implemented nationally by the Liberals...
...No dot matrix submissions, please...
...George Bush decorated his election campaign with medical horror stories that turned out on investigation to be largely the invention of feverish speechwriters...
...Ontario's social democratic government has forced hospital mergers, encouraged the training of midwives, and capped payments to citizens who journey south to explore private enterprise medicine in the United States...
...Please use inclusive language so that we don't have to make adjustments during editing...
...Medicare is finn• 11•••n SPRING • 1993 • 149 Clinton Proposes, We Respond nanced by premiums and, increasingly, by extra taxes...
...Justice Emmett Hall, the revered architect of the system, out of retirement to proclaim that Medicare would be unaffected...
...Most Canadian provinces spend a third of their budgets on health and hospitals...
...Canadians needed to be reassured about Medicare before the FTA would be accepted...
...Some provinces are rethinking coverage of prescription drugs for seniors, optometry, physiotherapy, and chiropractic treatment...
...In 1964 and 1965, a federal royal commission headed by Mr...
...When Ontario banned "extra-billing" in 1986, many doctors closed their offices...
...Despite complaints that costs were rising out of control, he could argue that Canadians paid far less for a universal health care system than did Americans for a system that left twentyfour million people without any protection...
...It reiterated the original principles and penalized provinces that charged "user fees" for essential services or allowed doctors to bill patients for more than the Medicare rate...
...THE EDITORS El 150 • DISSENT...
...As part of the settlement, the government agreed to pay doctors on a "fee-for-service" basis, allowing doctors to control the pace of their work and, incidentally, increasing the "paperwork" that doctors had professed to deplore...
...High-tech medicine and an aging population with bigger health needs keep pushing Canada's medical bill higher...
...Justice Hall reviewed Medicare, found 97 percent of Canadians covered, and reported that Canada had, "by world standards, one of the very best health services today...
...In fact, most Canadians think Medicare gives them a big advantage over Americans...
...Struggling to be neutral on a highly politicized question, Consumer's Guide had trouble finding fault with the Canadian system when it compared costs and benefits with American experience...
...2) Please don't write to ask whether we're interested in such and such an article—it makes for useless correspondence...
...4) Notes and footnotes should also be typed double-spaced, on a separate sheet...
...As we're not an academic journal, we prefer that they, wherever possible, be dropped altogether or worked into the text...
...Ottawa agreed to pay half the cost of any provincial plans that met five principles: accessibility, universality of coverage, portability from province to province, comprehensiveness of services, and government administration...
...The pro–free trade Conservatives were sufficiently alarmed that they brought Mr...
...Check all your figures, dates, names, etc...
...This time, opposition was fierce...
...Whether or not the aged judge was 148 • DISSENT Clinton Proposes, We Respond right, the symbolism was significant...
...Inspired by Lloyd George's early ventures in health insurance in Britain, Canada's Liberal party promised national health insurance in its 1919 platform and again in 1945...
...We will not consider manuscripts submitted simultaneously to several publications...
...5) We're usually quick in giving editorial decisions...
...they're the author's responsibility...
...Would-be Democratic presidential candidate Paul Tsongas insisted that in Canada he could never have had the scarce and expensive medical treatment he needed—although he seems to have been ignorant of the fact that the procedure was developed and available in Toronto and elsewhere...
...Like any institution managed by humans and MISSISSAUGA, ONT...
...use Word perfect 5.1 if possible...
...Doctors, hospital administrators, pharmaceutical firms, and other medical interest groups say Canada should be spending more on health...
...For those on both sides of the border who believe that health care is a social right, best financed, like defense and environmental protection, from the common wealth, Canadian experience proves that it can be done well and economically, but only if all five of Canada's principles are respected...
...Or take a chance and send us your article...
...The CCF victory in Saskatchewan in 1944 led to the first province-wide hospital insurance plan in Canada in 1947...
...On July 1, 1962, 90 percent of them closed their offices and went on strike for twenty-three days...
...During the furious national debate over the Canada-U.S...
...Medical associations bargained with provincial governments on behalf of their members and, in some provinces, have secured binding arbitration...
...For about 8 percent of their gross national product (substantially less than Americans spend) and a possible wait for a nonlife threatening operation, Canadians have no worries about medical or hospital bills...
...6) Please bear with us—we have accumulated quite a backlog of material, and you may have to wait for a few issues before you see your article in print...
...Pennsylvania Senator Harris Wofford won election in part on his promise to introduce a Canadian-style system...
...Opposition soon faded, the plan spread, and by 1960 some 99 percent of Canadians were covered by government-run insurance against basic hospital bills, though private plans continue to offer additional coverage for private rooms and loss of income...
...Whatever their attitude to socialism, Saskatchewan voters liked Medicare...
...If there's a delay, it's because a few editors are reading your article...
...40 billion a year...
...The CCF government won a popular mandate for Medicare and stayed on course despite furious opposition from physicians and their backers...
...Corporate Canada has backed the multinational drug companies in their bid to eliminate low-priced generic pharmaceuticals...
...Hall's report, with its impeccably conservative credentials, coincided with a period of national prosperity and self-confidence...
...Though Medicare has critics who think Medicare costs too much and others, mainly health professionals, who want more spending, it remains by far the most popular of Canada's social programs...
...Administered by ten provincial governments, regulated and partly financed by the national government, Canada's health insurance system pays for basic medical and hospital bills for all Canadians...
...Already the right-wing Reform party insists that universal health insurance is a luxury Canadians cannot afford without heavy deterrent fees for users...
...In the current recession, failing revenues have forced governments to control costs through community-based health care, caps on doctors' earnings, reductions in hospital beds, and an emphasis on personal fitness and prevention...
...Since 1982, Ottawa has limited its contribution to provincial Medicare bills, but costs keep rising...
...They soon found that public opinion was so strongly against them that they returned...
...Despite Mr...
Vol. 40 • April 1993 • No. 2
