The government brought doctors from Britain and encouraged others to come from the US and other parts of Canada to meet the emergency. Local citizens groups organized medical clinics and hired doctors to attend them.
By mid-July much of the KOD support had dissipated. Some doctors were returning to work; the force of the strike was spent. At the beginning of August, the government made some amendments to the Act; one amendment allowed doctors to practice outside the plan.
After 23 days on strike, the Saskatchewan doctors returned to work. But hostilities remained long afterwards; patients resented their doctors' desertion and doctors continued to object to government involvement in medical care.
Nevertheless, a survey found that most doctors favoured continuing the plan. The Saskatchewan government had opened the door to universal health care.
Within ten years of the Saskatchewan strike, the entire country was covered by medicare. Challenging Authority Quebec asbestos miners launch a bitter strike foreshadowing a revolution in French Canadian society read more Great Expectations The Fight for Medicare. The Fight for Medicare Saskatchewan faces a bitter doctors' strike over Canada's first universal health care plan "We feel we cannot practice under state-controlled medicine.
Socialist politician Tommy Douglas was the force behind Canada's first universal health insurance plan, enacted in Saskatchewan in In , health expenses drove more Americans into bankruptcy than any other reason, according to the American Journal of Public Health. That same year, health care consumed 17 percent of the U. Taxes cover the cost of hospital care, such as emergency room visits or operations to remove tumors.
Patient advocate Carolyn Canfield, who lives in British Columbia, has had to confront a life-threatening cancer diagnosis, but not the endless medical costs that many in the U. Born and raised in the U.
More than a decade ago, she noticed suspicious symptoms. She saw her doctor who referred her for testing. The biopsy revealed a malignant growth, and her doctor referred her to a specialist. Age and osteoporosis had taken their toll, and she was ready for the relief an elective surgery would bring, he said. She underwent diagnostic tests and consulted with doctors. Within three days of her operation, Tinani said, Canada entered lockdown due to COVID and hospitals stopped conducting elective surgeries.
Several more months passed. However, because of her age, concerns about the virus and coordinating family members to care for her during her recovery, Tinani said his mother chose to postpone her knee replacement. Mira and her twin sister, Jaya, were born 10 weeks premature and fought infections after birth. They received weeks of care in the Canadian hospital system, and their family was charged nothing.
His mother, 78, has waited for roughly a year to undergo knee replacement surgery, an elective procedure. Photos courtesy of Naresh Tinani. The amount of time Canadians wait for medical care depends on the type of procedure, and wait times have shifted over time.
The Canadian Institute for Health Information tracks provincial-level data on wait times for elective procedures for non urgent outpatient specialty services, such as cataracts and hip replacements. Some provinces are better at meeting benchmarks than others. At the same time, a senior with bad or painful arthritis may have to wait a year for hip replacement surgery, Martin said.
For roughly 20 years, Wendell Potter worked to sow fear of the Canadian health care system — including long wait times like these — in the minds of Americans. As the head of corporate communications for health insurance giant Cigna, Potter said industry executives felt the public Canadian system exposed shortcomings in the private U.
That led Potter and his peers to perpetuate the idea that wait times forced Canadians to forgo needed medical care and live in peril. In this case, Canadians at the time experienced longer wait times for non-emergency elective procedures, such as knee and hip replacements. Massive health insurance companies poured money into promoting this idea until it bloomed into a mischaracterization of the entire Canadian health care system. In , he abandoned corporate communications after he was told to defend a company decision not to pay for the liver transplant of year-old Nataline Sarkisyan , despite doctors saying the procedure would save her life.
She died. He is now president of Medicare for All Now, an advocacy group that promotes universal health coverage. In [the U. Even routine childhood vaccinations nosedived during the pandemic, pushing the U. Department of Health and Human Services on Aug. When the U. They tossed into the echo chamber the fact that Americans stood a better chance of surviving breast cancer than Canadians.
They neglected to say Canadians were more likely to live after a cervical cancer diagnosis than Americans. In fact, Canadians enjoy better health outcomes overall than Americans, from infant mortality to life expectancy. During the COVID pandemic, Canada has seen many fewer cases and illnesses, but the difference is not proportionate. The Committee agrees that this central element of our system must be maintained, provided that the system meets appropriate standards for high-quality services delivered in a timely manner.
Many witnesses told the Committee that giving primary financial responsibility to a single funder provides the Canadian health care system with a more efficient administration of health care insurance than is possible under a multi-funder system. Another strong argument in favour of public health care insurance is the fact that very few Canadians can afford not to be covered. It therefore makes sense to have everyone covered by a single plan.
A single insurer system providing universal coverage also means that no one will deny themselves needed health care because they have what they feel to be a more pressing use for their money perhaps for food, shelter, clothing, etc.
Nor will anyone be denied necessary care due to their inability to pay. Yet another important advantage relates to the principle of risk sharing. The more who share the risk all Canadians , the lower the cost of insuring against all risks. The Committee also heard that a single insurer makes a lot of economic sense for Canadian industry and is an important element of Canadian competitiveness.
We should not lose these advantages. A single funder model implies that there will not be, within Canada, a parallel, private insurance sector that competes with public insurance for the funding of hospital and doctor services under the Canada Health Act , at least in those hospitals and with those doctors that care for publicly insured patients. We point out, however, that parallel public and private health care systems exist in most other industrialized countries. In Chapters Five, Six and Sixteen, the Committee has raised the concern that laws that, in effect, prevent the development of a parallel private system, and hence help preserve the principle of public administration of the Canada Health Act, may be struck down by the courts if the publicly funded and insured health care system fails to provide timely and quality care.
Should this happen, the principle of public administration would have to be revisited. As noted in Volume One, it is equally important to understand clearly what the public administration principle of the Canada Health Act does not mean. This principle refers to the administration of health care insurance coverage; it does not deal with the delivery of publicly insured health services.
The Act does not prevent provinces and territories from allowing private for-profit and not-for-profit health care providers, whether individual or institutional, to deliver, and be reimbursed for, provincially insured health services, so long as extra-billing or user charges are not involved. This is, in fact, what Canadian Medicare has been from the start — a national health care insurance program based primarily on the private both for-profit and not-for-profit delivery of publicly insured hospital and doctor services.
The Committee is concerned that the principle of public administration is poorly understood, particularly because of the confusion between administering public health care insurance and delivering publicly insured health services.
This would greatly improve the current debate about health care in this country. The principle of public administration of the Canada Health Act be maintained for publicly insured hospital and doctor services. That is, there should be a single insurer — the government — for publicly insured hospital and doctor services delivered by either public or private health care providers and institutions. The federal government, through Health Canada, clarify the meaning of the concept of public administration under the Canada Health Act so as to recognize explicitly that this principle applies to the administration of public health care insurance, not to the delivery of publicly insured health services.
Prescription drug coverage is currently provided by many insurers, ranging from governments to private insurance companies. In fact, the private drug insurance industry is already well established in Canada and it appears to be functioning well. The Committee believes, and has recommended in Chapter Seven, that the expansion of coverage to include catastrophic prescription drug costs should be based on a partnership between the public and the private sectors to ensure universal coverage for catastrophic drug costs.
The Committee has no hesitation in saying that in-depth reform of the publicly funded hospital and doctor system can take place within the five national principles of the Canada Health Act. We believe that the Act has served Canadians relatively well in terms of providing universal and uniform coverage for hospital and doctor services.
We feel that the four patient-oriented principles of the Act should be maintained for hospital and doctor services, while the principle of public administration should be clarified.
However, the Committee believes that Canadian Medicare and the Canada Health Act must be supplemented by two new pieces of legislation. First, as explained in Section This legislated health care guarantee will improve access to the set of hospital and doctor services that are currently insured under the Canada Health Act.
While principles other than those of the Canada Health Act are needed for the new programs proposed in the report, the underlying value related to those services, namely, providing high-quality services on the basis of need, should remain. Similarly, access to reasonably comparable services for all Canadians everywhere in the country must be assured under the legislation covering the new programs. This comparability requires the development of national standards.
These should apply to all publicly funded services, whether delivered by private for-profit, private not-for-profit or public health care providers and institutions. The federal government enact new legislation instituting health care coverage for catastrophic prescription drugs, post-hospital home care and some palliative care in the home. This new legislation should explicitly spell out conditions relating to transparency of decision making and accountability.
Implicit in these two objectives, particularly the first, is the requirement that the medically necessary services provided under Medicare be of high quality. This value of fairness underlies the patient-oriented principles of a universal, comprehensive, portable and accessible system that the Committee — and Canadians — strongly support.
But, to Canadians, fairness also means equity of access to the system — wealthy Canadians should not be able to buy their way to the front of waiting lists in Canada. Repeated public opinion polling data have shown that having to wait months for diagnostic or hospital treatment is the greatest concern and complaint that Canadians have about the health care system.
The solution to this problem is not, as some have suggested, to allow wealthy Canadians to pay for services in a private health care institution. Such a solution would violate the principle of equity of access.
The solution is the care guarantee as recommended in this report. Based on evidence presented at Committee hearings over the past two years as well as on public opinion polling data, the Committee is also aware that Canadians believe that the current system is inefficient. Moreover, Canadians are not prepared to invest additional money into the system until these inefficiencies are eliminated. The Committee realizes that changing this public perception of an inefficient system will not be easy.
It will require the introduction of incentives to encourage all the components of the system to function more efficiently. It will also require that the system function in a much more transparent and accountable fashion, including in the ways in which public money is spent. In formulating its recommendations, the Committee also took account of two additional factors. First, the Committee believes that if the second public policy objective given above — the no undue financial hardship objective — is to be met, steps must be taken now to begin to close the major gaps in the health care safety net.
While the Committee believes that Canadians who are genuinely in need of help, and cannot afford to pay for it, should receive the assistance they need from public funds, this does not mean that what is needed are new first-dollar coverage programs in areas such as pharmacare or home care. Moreover, the payment method must be described in terms that are meaningful to individual Canadians. The only way Canadians can develop an informed opinion on the merits of a proposed plan of reform is if they can clearly understand the benefits that will result from the plan, and what it will cost them to have the plan implemented.
It is for this reason that the Committee has taken the extremely unusual some have even described it as unique step of both costing our recommendations and putting forward a recommended option for raising the new federal revenue required to implement fully our recommendations.
This would play directly into the hands of those who oppose reform. Not to give a revenue-raising plan would also mean that the Committee had failed to meet the test of transparency and accountability, which it has insisted throughout its recommendations must apply to the health care system as a whole.
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