Making Medicare : New Perspectives on the History of Medicare in Canada

The Canadian health care system is so indisputably tied to our national identity that its founder, Tommy Douglas, was voted the greatest Canadian of all time in a CBC television contest. However, very little has been written to date on how Medicare as we know it was developed and implemented. This collection fills a serious gap in the existing literature by providing a comprehensive policy history of Medicare in Canada. Making Medicare features explorations of the experiments that predated the federal government’s decision to implement the Saskatchewan health care model, from Newfoundland’s cottage hospital system to Bennettcare in British Columbia. It also includes essays by key individuals (including health practitioners and two premiers) who played a role in the implementation of Medicare and the landmark Royal Commission on Health Services. Along with political scientists, policy specialists, medical historians, and health practitioners, this collection will appeal to anyone interested in the history and legacy of one of Canada’s most visible and centrally important institutions. Contents 5 Foreword 7 Editor’s Preface and Acknowledgments 9 1. Canadian Medicare: Why History Matters 11 Part One: National History of Medicine 31 2. The Foundations of National Public Hospital Insurance 31 3. Into Thin Air: Making National Health Policy, 1939-45 51 4. The Liberal Party and the Achievement of National Medicare 81 5. Political Cartoonists Respond to Medicare 99 6. After Medicare: Regionalization and Canadian Health Care Reform 120 Part Two: Individual Provincial Histories of Medicare 147 7. Four Precursors of Medicare in Saskatchewan 147 8. The Road Not Taken: The 1945 Health Services Planning Commission Proposals and Physician Remuneration in Saskatchewan 161 9. The Hoadley Commission (1932-34) and Health Insurance in Alberta 193 10. From Bennettcare to Medicare: The Morphing of Medical Care Insurance in British Columbia 217 11. Newfoundland’s Cottage Hospital System: 1920-1970 239 12. The Partnerships between the State and For-Profit Hospitals in Quebec, 1961-1975: A Disappointing Experiment 259 Part Three: Oral History and the Birth of Medicare 287 13. The Struggle to Implement Medicare 287 14. Working for Medicare 292 15. A Physician on the Front Line of Medicare 294 16. My Experience in the Medicare Battle and the Woods Commission 298 17. A Brief Retrospective on the Royal Commission on Health Services 301 Conclusion 305 18. A New Prescription: Adding Historical Analysis to Health Policy 295 HEATHER MACDOUGALL 305 Contributors 317 Index 321