In the discussion thread: Krugman: If Obamacare can work in a state of 38 million people, it can work in America as a whole [View all]
Response to joshcryer (Reply #17)
Mon Nov 25, 2013, 12:50 PM
polly7 (13,678 posts)
26. Not quite.
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 CMA strategy backfired. Diefenbaker appointed fellow Conservative and old seat-mate from law school, Mr. Justice Emmett Hall, to chair the Royal Commission. The Commission was intended to examine all aspects of Canadian health care. However, the public hearings overlapped with the debate then raging in Saskatchewan that was becoming a major issue in the House of Commons and beyond. Dennis Gruending, in his superb biography of Emmett Hall, describes the excitement around the hearings, which played to packed houses around the country. Labour and farm organizations, consumer groups, community associations and many churches recommended a public plan similar to the one introduced in Saskatchewan in the midst of such controversy. The CMA, the private insurance industry and their business allies wanted the government to endorse the plans already operating under the auspices of organized medicine and the insurance companies. People could pay their own premiums, with the government subsidizing the premiums of the poor based on means tests. Gruending points out that Hall examined the evidence objectively and came down on the side of public Medicare, and then convinced those who were skeptical to go along with it. The first volume of the commission report, issued in June 1964, came out in favour of a comprehensive health insurance program to be jointly financed by the federal and provincial governments. “Although he didn’t admit it in the report, Hall’s proposal was essentially the Saskatchewan model on a national scale,” Gruending wrote.
The reaction to the Hall Report could probably best be summed up with the expression “all hell broke loose.” The usual suspects mounted a rhetorical battle on a national scale, generally divided along class and ideological lines. Emmett Hall, by now elevated to the Supreme Court, threw himself into the debate in favour of public Medicare, an unprecedented move for a Supreme Court Justice and Chairman of a Royal Commission. By 1964 the pro-Medicare forces in the country were riding the crest of public opinion during a period when the political culture was moving to the left. The political alignment of national parties saw six years of minority governments over three elections between 1962 and 1968, and this favoured those political forces attempting to move the country in a more progressive direction. The NDP was growing and this strengthened left Liberals who argued that their party must protect their left flank. This in turn encouraged the red Tories within the Progressive Conservatives, who argued that the party must move left to remain electorally competitive. All of this was occurring during a minority situation when an election might occur at any time and no party wanted to be caught on the wrong side of a popular issue like public Medicare.
It took fierce struggles within both the Liberal and Progressive Conservative parliamentary parties, but in the end the party whips forced the right wing into submission. The National Medical Care Insurance Act was passed in the House of Commons on December 8, 1966, by an overwhelming vote of 177 to 2. The starting date was July 1, 1968, and the Act provided that the federal government would pay about half of Medicare costs in any province with insurance plans that met the criteria of being universal, publicly administered, portable and comprehensive. By 1971 all provinces had established plans which met the criteria. Forty-five years later, the right to universal and equitable Medicare is now in perhaps the greatest danger it has faced since 1970. The political culture has lurched dangerously to the right and the Harper government has essentially declared that it has no intention of enforcing the Canada Health Act. The popular forces which made Medicare possible will have to be revitalized if we are to preserve the achievements which took decades of struggle to accomplish.
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