>I had just that thought when I read the story in the NYT this morning
><http://www.nytimes.com/2003/12/02/international/americas/02CANA.html>:
>
>>The nations remain like-minded in pockets, but the center of
>>gravity in each has changed. French-speaking Quebec, with nearly a
>>quarter of the population and its open social attitudes, pulls
>>Canada to the left, just as the South and Bible Belt increasingly
>>pull the United States in the opposite direction, particularly on
>>issues like abortion, gay marriage and capital punishment.
>>
>>None of those have resonated much over the last decade in Canada,
>>where the consensus on social policy seems more solidly formed, its
>>fissures narrower and less exploitable.
>>
>>Chris Ragan, a McGill University economist, observed: "You can be a
>>social conservative in the U.S. without being a wacko. Not in
>>Canada."
What made Canada what it is -- far to the left of the United States -- isn't French-speaking Quebec. What made the greatest difference was an originally socialist third party, the Cooperative Commonwealth Federation, born of an alliance of organizations of socialists, farmers, and workers; see the CCF's 1933 "Regina Manifesto" ("We aim to replace the present capitalist system, with its inherent injustice and inhumanity, by a social order from which the domination and exploitation of one class by another will be eliminated, in which economic planning will supersede unregulated private enterprise and competition, and in which genuine democratic self-government, based upon economic equality will be possible") at <http://www.mail-archive.com/pen-l@galaxy.csuchico.edu/msg38793.html>. The CCF first succeeded in taking provincial political power and implementing health care reform in "the prairie province of Saskatchewan."
***** THE POLITICS OF CANADA'S HEALTH CARE SYSTEM Elaine Bernard, Executive Director Harvard Trade Union Program, 1350 Massachusetts Ave., # 731 Cambridge, MA 02138
. . . How did they get it?
The general principles of the national health care system were established in 1959 in the prairie province of Saskatchewan by Canada's social democratic party and predecessor to the New Democratic Party (NDP), the Cooperative Commonwealth Federation (CCF). Long committed to health care for all, the CCF was first elected provincial government in Saskatchewan in 1944. During their first term in office in 1947, they introduced a province-wide public hospital insurance plan. Within a few years, this program was sufficiently popular that the other provinces adopted similar schemes.
In 1958, the provincial and federal governments worked out an arrangement to share the costs of the provincial hospital insurance programs. In Saskatchewan, this meant that provincial funds were now freed up to undertake further health care reform. In the 1960 provincial election, the CCF/NDP promised to introduce a comprehensive provincial health care system. Voters were told that a system of comprehensive medical service coverage for all, with affordable premiums subsidized by general revenues, was now possible. This system would emphasize prevention and early diagnosis and treatment, and was to be co-ordinated with other existing health programs, such as hospital insurance. It was to promote medical research and education and to emphasize the value of human life. Finally, reflecting the concerns of a rural province, the program was to seek ways of encouraging the best distribution of doctors throughout the province.6
The CCF won the 1960 election, in spite of a well-funded campaign by doctors in opposition to the health program. As the government proceeded to put its program into legislation through the Saskatchewan Medical Care Insurance Act (1961), the doctors continued their campaign against what they termed "socialized medicine." Accusing the government of "communism" and "compulsory state medicine," the doctors warned that the province was interfering with their right as professionals to practice medicine and was attempting to make them "salaried government employees." They warned that doctors would leave the province rather than work under such a system. Finally, in a last-ditch effort to force the government to back down on its health care reform, the doctors went on strike on July 1, 1961, the first day the new legislation came into effect.
The doctors' strike in Saskatchewan lasted 23 days and gained worldwide attention. While the doctors agreed to maintain emergency services and the provincial hospitals remained open with reduced staff, most private practitioners closed their offices. Ironically, the mortality rate in the province declined during the strike, primarily because of the decline in surgery.
While much of the national and international media condemned the doctors action, the local media supported the doctors and demanded that the government back down on its program. In spite of the local media's support, as the strike wore on public opinion in Saskatchewan turned against the doctors. As communities started to recruit doctors willing to work under the health plan from other parts of Canada, the local doctors' resolve rapidly dwindled. The strike ended with the new health program still intact. The provincial government negotiated a face-saving agreement with the doctors which permitted them to opt entirely out of the plan and bill patients privately. With over 900 doctors in the province at the time, none chose this option. The agreement also permitted doctors to maintain their own medical insurance companies as clearinghouses for the Medical Care Commission, though these were eventually eliminated by the doctors themselves as needless duplication.
In spite of the controversial start to the Saskatchewan program, it quickly proved to be a success. Within a few years, the Saskatchewan model became the prototype for other provinces. Similar to what had happened with the ground breaking initiative on hospital insurance, once the Saskatchewan model was in place the federal government passed legislation in 1966 which established the guidelines for a national health care system. The speed of the spread of the new system is impressive. By 1971, less than ten years after the introduction of the Saskatchewan system, every province in Canada had established a single payer, universal, comprehensive health care plan. . . .
<http://www.htup.harvard.edu/eb/healthc.pdf> *****
We'll never be able to emulate Canadians while being stuck with the Democratic Party. -- Yoshie
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