Wednesday, February 29, 2012

The College of Medicine and the “Doctors’ Strike”

University of Saskatchewan Archives

Doctor's strike in Saskatchewan during the Medicare Crisis, 1962 (National Archives of Canada, PA-88485).

July 1, 1962 was the scheduled date for implementation of Saskatchewan’s long-awaited public medical insurance plan. The “organized medical profession” in Saskatchewan, represented by the College of Physicians and Surgeons, was firmly against the plan, and a withdrawal of services took place on July 1.

Since the College of Medicine had a large clinical faculty, it is hardly surprising that the “doctors’ strike,” and the debates relating to medicare, had a direct impact on the College. There were conflicting reports about the extent of that impact, and how many College of Medicine doctors were supporting the strike. Dean R.W. Begg, was anxious that the College remain neutral in the dispute. The Dean also contacted other Canadian medical schools and made contingency plans to ensure that in the event of a “prolonged withdrawal of services” his students would be able to continue their studies.

One department that was affected was Social and Preventive Medicine. Samuel Wolfe, a professor in that department, had made trips to Britain to recruit doctors to practice in Saskatchewan under the medicare plan. In early July, Wolfe resigned from faculty and became one of the organizers of the Saskatoon Community Clinic. The new British doctors were key to the Clinic’s early development and survival.

The strike ended on July 23. The overall impact of the medicare crisis on the College of Medicine is difficult to assess. It is known that at least five full-time clinicians left because of the crisis. However, the number of applications for enrolment increased significantly after 1962. Samuel Wolfe and Robin Badgley (both originally in the Department of Social and Preventive Medicine) lamented an opportunity lost: “As a result of the medical school’s inability to tolerate differences of opinion on the medical care controversy, the opportunity was lost to assess the impact of the legislation critically and scientifically. The university, which should have taken the lead in assessing the impact of medicare on the health of the population and the quality of the medical services given by the doctors, and which should have been finding answers, did not even ask questions.”

The Battle for the NHS

By Alex Doherty, Colin Leys, Ed Lewis
New Left Project
February 29, 2012

Colin Leys is an honorary professor of politics at Goldsmiths College London, who has worked in the UK, Africa and Canada, and whose latest book is The Plot Against the NHS (with Stewart Player). He spoke to NLP co-editors Alex Doherty and Ed Lewis about the political struggle over the NHS and considers what those determined to save it can still do.

Given the unpopularity of the Health and Social Care Bill some commentators have suggested that this might become a poll tax moment for the government. Is this a realistic assessment of the damage the bill may do to the government and, if so, why do you think they are persisting with it?

The analogy with the Poll Tax is relevant but not exact. The poll tax was a very simple issue, and very plainly unjust. It also required citizens to do something – to pay the tax – and when enough of them felt angry enough, and when the anger was widespread enough, a significant minority decided to risk jail and refuse to pay, creating a serious crisis of legitimacy. In contrast, the Health Bill is hugely complex, its real meaning has been deliberately obscured, and it doesn’t require citizens to do anything. The poll tax was also introduced in Scotland first, aggravating Scottish resentment of all Thatcher’s policies, whereas the Health Bill only applies to England, where a social democratic culture is less strongly entrenched.

A further difference is that the poll tax was firmly identified with Thatcher personally, whereas Lansley, it is said, lacks strong support both in the parliamentary party and among the Conservative rank and file.

Canadian national healthcare’s big benefit

Workers don’t keep jobs they don’t want just for health insurance

By Bill Mann
February 28, 2012

PORT TOWNSEND, Wash. — A major assault is underway by Republican candidates for the White House against President Barack Obama’s Patient Protection and Affordable Care Act, which they persist in calling “Obamacare.” Contraception has become an unlikely issue in all this.

Before “Obamacare” passed, it was Canada’s single-payer national health care system that was often under attack — in the U.S., that is. Even though Canadians treasure their health-care system despite its flaws, Americans were told for years — actually, lied to — that Canadians were being denied urgent care and had to flee to the U.S. to get it.

They didn’t, and they don’t. As a Montreal friend assured me the other day, “If you need help, you’ll get right in. For some other things, you may have to wait a bit.”

Canada spends far less per capita on health care (a bit more than half as much) than the U.S. The fact that socialist Saskatchewan premier Tommy Douglas, the father of Canadian national health care — not Wayne Gretzky — was voted The Greatest Canadian Ever by his countrymen in a Canadian Broadcast Corp. poll a while back should tell you something.

Tuesday, February 28, 2012

Same fight, new foes

Fifty years after the birth of medicare, Canada’s health care system is again under threat

Taylor and Brown
July 1, 2012, will mark the 50th anniversary of the birth of medicare in Saskatchewan, the forerunner of Canada’s national medicare system. It was not an easy delivery. In the summer of 1962, Saskatchewan was beset by a doctors’ strike intent on preserving physician privileges and opposing public health care.
Fifty years later, Canada’s medicare system is again under threat. Harper’s Conservatives have unveiled a plan to scale back health-care funding, destroying medicare as we know it. The ideology of neoliberalism has taken root over the past two decades, and austerity and privatization remain capital’s preferred strategy. But there was a different alignment of political players and social movements 50 years ago when medicare was first fought for.

Saturday, February 25, 2012

Mending Medicare

Mending Medicare: Special 24-Page Supplement on how to improve Medicare from the Canadian Health Coalition and Canadian Centre for Policy Alternatives, 2006

Political Cartoonists Respond to Medicare

Volume 26:2 2009 / p. 333-351
Also see Cartoons (Medicare: A People's Issue)

Debates about health care policy are a rich topic for editorial cartoonists.

The 17 cartoons described here, from the period 1944 to 1986, cover the implementation of universal hospital and medical care insurance as well as the subsequent passage of the Canada Health Act.

These cartoons by Canada’s major cartoonists trace the issues arising from debates over Medicare with characteristic wit and vigour, as they draw on an existiing repertoire of visual imagery relating to doctors, patients and health care.

Read more HERE. (pdf)

Thursday, February 23, 2012

Three Weeks in July: The Response of the Press to the 1962 Doctors’ Strike in Saskatchewan

By Murray McEachen

"...the three weeks in July 1962, in Saskatchewan, were truly a turning point in Canadian history"

For three weeks in July 1962, the attention of Canadians and the nation’s press was focused on Saskatchewan, for it was there that the province’s doctors were going to collectively withdraw their services. In effect, they were going to go “on strike.” William Thompson, who was Managing Editor of the Regina Leader-Post in the summer of 1962, said that the dispute was voted by the wire editors of Canada as the top story of the year, and Woodrow Lloyd’s biographer called the doctors’ strike the news event of the decade. As such, it drew media from across Canada to Saskatchewan at its peak.

The doctors, represented by the Saskatchewan College of Physicians and Surgeons, led by Dr. Harold Dalgleish were protesting the enactment of the Saskatchewan Medical Care Insurance Act by the provincial government, led by Premier Woodrow S. Lloyd. Successful implementation of the Act would mean that a socialist government had put in place a comprehensive medical care plan for the first time in North America.

Many, therefore, viewed it as a test by fire for the Canadian left. The federal government had been pondering the issue of medicare since the 1940s and had established the Royal Commission on Health Services headed by Justice Emmett Hall in 1961. Ottawa would no doubt maintain a weather eye, through the looking glass of the press, at the events as they unfolded in Saskatchewan. The question put forth in this paper is how did the story, as reflected in the editorial pages of Canada’s daily newspapers, affect the medicare debate at a national level?

Read this paper HERE.

Review press clippings from Saskatchewan HERE.

UK: An end to Bevan’s dream of free healthcare for all Britons?

By Allyson Pollock
Our Kingdom
20 February 2011

The Government’s Health and Social Care Bill published on 19th January is now in the Committee stage, having passed its second reading in the Commons by a majority of 86. But if the Bill is passed without major amendments it will forever be known as the “abolishing the NHS” Bill. If enacted, up to 100 billion pounds annually of taxpayers money is likely to be handed over to large corporations that will run and operate our NHS services for profit. Make no mistake, the NHS will be there but in name only: health services will be run on US lines by, and largely for, shareholders and profit, while denial of care will escalate.

Tuesday, February 21, 2012

Italy’s healthcare crisis

Il Fatto Quotidiano
February 21, 2012

The entrance of the Umberto I Polyclinic
Forty five thousand less beds and overall hospital capacity reduced by 15%, twelve hour waits in A&E and serious staff shortages: these are the headline results of official figures covering the past decade that have been analysed by Il Fatto Quotidiano newspaper.

The picture in big cities is the most serious with health services ‘close to collapse’ in Rome, Turin and Naples, according to data studied by the paper.

The number of beds per thousand inhabitants has fallen from 5.1 to 4.2 in 12 years, leaving Italy well below the European average of 5.5 beds per thousand inhabitants.

Cuts in hospital capacity were supposed to be balanced by the expansion of non-acute ‘community’ services under reforms pursued over the past decade, but this has not materialised.

Increased waiting times for public health services and a cut in capacity - the public health system has seen a 17% cut in capacity compared to 5.3% for the private sector – have seen in increase in the use of private clinics in 12 out of the country’s 20 regions.

Severe cuts over the past 15 years has gone hand in hand with healthcare reforms that granted powers to regional administrations to spend centrally provided funds as they saw fit. This resulted in a freeze on hiring healthcare workers, the use of an increasingly casualised workforce and healthcare shopping whereby people (who can) travel to the best facilities typically, in the richer north, creating a postcode lottery of care.

The reforms also allowed a big expansion in state-funded private providers.

For example, Veneto region, run by the extreme right wing Northern League splashed out over a four year period Euros 200 million of taxpayers money to private clinics.

Private clinics, some of which have church links, are also a key target for investment from organised crime and there has been a number of high profile financial scandals linked to them.

The country spends 9% of its gross domestic product on healthcare, putting it behind the UK, France and Germany.

Drumming Up a Healthcare Crisis: The Drummond Report’s Implications for Health Policy

By Justin Panos
Socialist Project Bullet
February 21, 2012

In a Maclean's interview in November 2008, former TD Bank Chief Economist (2000-2010) and head of the eponymously titled ‘Drummond Report’ spoke truer than he might have then known. Don Drummond, who spent 23 years in the Federal Ministry of Finance, was asked if he missed “being in the middle of the action,” to which he replied:

“There's definitely a buzz from being there when the economy is turbulent, and I would be surprised if there weren't people in the government who didn't take some perverse...pleasure's the wrong word, but interest in what's going on. You don't wish for anybody to lose their jobs or investments, but it is fascinating and there is an adrenalin rush; it taxes your analytical skills and your knowledge of history, looking back to see if there are parallels. It's great when everything's going smoothly, but more exciting when it's not” (author's emphasis).

Where to start? Drummond makes it clear that whether on Parliament Hill or Queen's Park, reputations are made or broken in a crisis. His name became equivalent with fiscal pragmatism after he helped Prime Minister Paul Martin return the federal government to an operating surplus in the late 1990s. Able to enjoy the feral experience of the Ministry of Finance during a crisis, Drummond's composure made him one of the most decorated public servants, the type for whom privatization is his most public utterance.

Saturday, February 18, 2012

The Year We Became Us: A Novel About the Saskatchewan Doctors Strike

Written by Gary Engler
Fernwood Publishing

The Year We Became Us is a novel about the 1962 Saskatchewan doctors’ strike as seen through the eyes of a 12-year-old boy and a 13-year-old girl. Roy, the son of a union activist, is a committed socialist and the best Little League pitcher in the entire province.

Katherine, the daughter of a surgeon, has fallen in love with two novels by Ayn Rand and aspires to be just like her. Both are forced to write letters to President Kennedy as punishment for always arguing politics in their Grade 8 class at Saint Michael’s Catholic School in Moose Jaw.

Part romance, part adventure and part political philosophy, this historical novel moves between1960s Moose Jaw and present-day Boston and follows Roy and Katherine as they revisit their letters to President Kennedy forty years later.

The 1962 Saskatchewan doctors’ strike was one of the pivotal moments in the creation of Medicare — the quintessential Canadian institution that sets us apart from our U.S. neighbours. To be released on the 50th anniversary of Canada’s first socialized medical plan, The Year We Became Us is a work of historical fiction portraying a crucially important moment in our history, one that is often overlooked or forgotten in contemporary Canadian society and by younger generations.


GARY ENGLER worked as a journalist for 20 years, including time as both a writer and editor at the Vancouver Sun. He is the author of The Great Multicultural North.

Co-published with: RED Publishing
Paperback ISBN: 9781552664827
Paperback Price: $19.95 CAD
Publication Date: Jun 2012
Rights: World
Pages: 264
unavailable until Jun 2012

Drummond: More Mike Harris than Mike Harris

February 15, 2012

As expected, the Drummond Commission has proposed the province shrink and privatize hospital services.

Drummond has recommended that health care funding be limited to 2.5% until 2017-18. This is considerably less than the 3.6% increase proposed by the Liberals not long before the election. That proposal caused the Auditor General to observe in his pre-election review of Ontario's finances that $1 billion in hospital savings would have to be made.

The main target for Drummond cuts in health care spending are hospitals.

Wednesday, February 15, 2012

Canada’s threatened health care system

2014 Accord compromises basic principles

FEBRUARY 15, 2012

Bridge River Lillooet News

I imagine the reader has heard about Stephen Harper’s recent take-it-or-leave-it proposition regarding Canada’s health care system. The aim of this commentary will be to clarify some of the issues involved.

First a little history: In 1947, the Saskatchewan government, led by Tommy Douglas, introduced the first provincial hospital insurance program in Canada. The federal government under Paul Martin Sr. followed in 1957 with a national hospital insurance program. Then, in 1962, Saskatchewan’s NDP government instituted the first public health care program.

Monday, February 13, 2012

U.S. citizens deserve better health care

The Gazette (Iowa)
February 13, 2012

Social Security and Medicare are not entitlements. We paid for this all the years we worked.

It started in 1935 with 99 percent of Republicans voting against it. In 1939, the Republicans tried again to kill Social Security. In 1982, President Reagan got the OK to use $33 million to fight unions out of the Medicare funds. The unions got this stopped. In 1977, 88 percent of the Republicans voted against payroll tax needed to keep Social Security solvent.

The Republicans and Democrats stole from Social Security. Republicans say they support Social Security but the record shows they do not. Now they are trying to defeat our new health care program.

We are the only industrial nation without national health care for our people. Thank you, Obama, and the Democrats for getting us health care reform.

If people are on disability and need care and qualify for it, they should have it. Life expectancy in the United States is the same as Cuba. Lower than Japan, Australia, Sweden, France, United Kingdom, Germany and Canada. They all have universal health care. They don’t have some insurance company saying no. Our health care insurance is deciding if we live or die. Canada gets its drugs for half of what we pay for ours. Pharmaceutical and insurance companies are controlling our health and cost. This has to stop.

Cliff Higgins
Cedar Rapids

Sunday, February 12, 2012

Video: The Saskatchewan Doctor's Strike of 1962

Saskatchewan doctor's strike resolved, July 23 1962

Medicare: A People's Issue

The Saskatchewan Doctors Strike ended on July 23 when the cabinet and the College of Physicians and Surgeons signed a 29-point memorandum. The deal, known as the Saskatoon Agreement, had been brokered by Lord Taylor largely from his hotel suite in Saskatoon. Though the settlement would mean significant changes to the Act, both sides had backed away from the original stands.

At the same time, each side was able to retain some of the characteristics they regarded as fundamental. The Act was to be amended in areas that the doctors felt threatened their independence of action while the principle of universality was maintained. Instead of one means of doctor payment there would be four:

  • Private contract. Paying the doctor directly with no compensation.
  • Patient reimbursement. Patient pays doctor and is then compensated by the government plan.
  • Doctor bills plan. The doctor sends the bill directly to the medicare plan.
  • Approved health agencies. Doctors’ insurance companies act as a clearing-house for the Medical Care Commission.

The necessary amendments were passed at a special one-day session of the Saskatchewan Legislature on 2 August 1962.

Below is the cover of the Saskatchewan Department of Public Health newsletter issued to the public outlining the new plan (click to enlarge).

Harper Sticks Provinces With Take-it-or-Leave-it Health Care Approach

Gregory Marchildon
Canada Research Chair
University of Regina
February 8, 2012

In December, the federal Minister of Finance announced that the federal government would extend the current six per cent annual escalator on the Canada Health Transfer (CHT) to 2015-16 and thereafter link increases in the CHT to the rate of economic growth with a floor of three per cent per year.

The announcement caught everyone -- pundits, governments, and experts -- by surprise. Most expected some sort of First Ministers' meeting to deal with the issue along the lines of the 2004 meeting between the Premiers and Prime Minister Martin that produced the last deal. Instead, provincial governments got a take-it-or-leave it proposition, putting them in the ridiculous position of complaining about aspects of the decision -- the escalator, the new per capita formula, and the unilateral nature of the announcement -- even as they accepted the money.

Thursday, February 9, 2012

Tanzanian doctors strike, civil society protests

Pambuzuka News
February 9, 2012

Thirteen leaders of national and grassroots activist organizations in Tanzania have been detained today by the government in the Oyster Bay Police Station, Dar es Salaam, in a government clamp down on protests by women/feminist and human rights activists against the failure of the government to resolve the health crisis arising from a two-week doctors’ strike in Tanzania.

The leaders come from LHRC, TGNP, GTI, TAMWA, NEDPHA and several other grassroots organizations. They and others were on their way to Muhimbili Hospital to await the outcome of talks which the Prime Minister was having with striking doctors. On Wednesday 8 February more than 200 activists successfully ‘occupied’ Salendar Bridge and the roads leading into it for two hours, and got major media attention and support from motorists and passersby for their action, based on the posters demanding that the Minister of Health and other top officials must resign; and protesting the failure of the President’s Office and the Parliament to give the situation priority. Countless numbers of people have died as a result of the strike. However, as the participating organizations such as TGNP have noted, people were dying long before this strike because of the lack of adequate human, financial and material resources provided to health care at all levels.

Many of the organizations leading the protest are members of the Feminist Activist Coalition, Fem Act, including TGNP, GTI, TAMWA, LHRC, HakiElimu, SIKIKA, and NEDPHA; others belong to Policy Forum, including Policy Forum itself.

Tuesday, February 7, 2012

Is this the end of Canadian medicare?

Stephen Harper once said ‘you won’t recognize Canada when I get through with it.’ It seems he’s starting with medicare.

The Hill Times
Feb. 06, 2012

 Hedy Fry, Liberal MP
PARLIAMENT HILL—The Conservative government’s announcement that it would impose cuts in federal health transfers after 2017, came as a shock to provincial premiers and health-care groups, who had been calling for a first ministers meeting on health care for more than a year. They were united in their condemnation of the unilateral nature of the decision and the subsequent refusal of the Prime Minister to meet with them to discuss the issue.

The Canadian federation has, over the last 50 years, attempted to function in a mutually respectful manner, with regular meetings and negotiated agreements between federal, provincial and territorial first ministers. Consequently, the unilateral health transfer decision was unprecedented and could be seen as a strong signal from the federal government that federal-provincial-territorial collaboration was at an end.

Monday, February 6, 2012

Canadian Health Care: Privatization and Gendered Labour

Pat Armstrong/Priscillia Lefebvre
Socialist Project
February 6, 2012

Priscillia Lefebvre is a collaborative Ph.D. student at the Department of Sociology and Anthropology, Institute of Political Economy, Carleton University (Ottawa, Canada).

Pat Armstrong is Professor of Sociology and Women's Studies at York University (Toronto, Canada). She held a CHSRF/CIHR Chair in Health Services and Nursing Research, focused on gender and chaired the group Women and Health Care Reform for more than a decade. She has published on a wide range of issues related to gender, health care and work. Pat was interviewed by Priscillia Lefebvre over August 2011.

Priscillia Lefebvre (PL): A large focus of your research seems to be the ways in which gender and labour intersect from the vantage point of health care delivery. What have been the main influences that have affected the trajectory of your research in terms of a feminist rooted political economy approach? Why is this approach so important in understanding the contradictions that exist regarding the role of women within health care?

Pat Armstrong (PA): It is difficult to identify the main influences on my thinking and research. Growing up in a family where community involvement was not only encouraged but required meant seeking engagement at university. Also, the red Tory approach in our household did not fit so comfortably with the Marx I read as a student in the 1960s or with the growing feminist movement I participated in. As Juliet Mitchell[1] explained, Marx was not good about women and did not provide a detailed blueprint for analysis, but he did offer a way to make systems transparent and to think about progressive change.

Sunday, February 5, 2012

We should honour Tommy Douglas’ vision

By Gregory Marchildon
National Post

Saskatchewan Archives Board

Tommy Douglas, centre, stands under a CCF billboard shortly after his election.
Last night in Toronto, as part of the Royal Ontario Museum’s History Wars series, professors Michael Bliss and Gregory Marchildon debated the legacy of medicare’s founder. 
As premier of Saskatchewan, Tommy Douglas was instrumental in introducing universal hospital insurance in 1947 followed by universal medical-care coverage in 1962. Without a doubt, these two pioneering experiments became the template for what we now call universal medicare in Canada. But it is essential to remember that rearranging the financing of the system so that everyone would have access to medically necessary care was only the first step for Douglas. The critical second stage was a fundamental reorganization of the delivery system to build in more illness prevention and health promotion, and extend care beyond hospitals and physicians. This, he recognized, was the more difficult stage, and he always hoped and expected Canadians to meet that challenge after he retired from political life.