If you think our fight for affordable universal health care with a public option is difficult, you should know something about what Canada went through. Or, more accurately, Saskatchewan, the first province to implement what has become known as the Canadian Health Care system. Or, as they call it, Medicare. For all.

In Saskatchewan, instead of having a large number of doctors in favor of such a plan, about 90% of the doctors actually went on strike in protest. A bitter strike that lasted from July 1, 1962 to July 23, 1962.

And in the end the plan started by Tommy Douglas and implemented by his successor Woodrow Lloyd, who faced tremendous pressure to withdraw the plan, was popularly adopted, with some provincial adpatations, over the whole of Canada within ten years.

And there lie a couple of things I think we can learn.

Canada went through a long gestational process in their eventual progress to a universal single payer system. It started with the Union Hospital Acto of 1916, took a giant step with Governor Tommy Douglas' Saskatchewan Hospitalization Insurance Plan (SHIP) in 1946, and made the big leap with the implementation of the-Premier Tommy Douglas' "Saskatchewan Medical Care Insurance Act" in 1962, and inevitably led to the current system of universal single payer, Medicare, by 1972. Since then there have been several rounds of finetuning. History source.

The initial implementation in Saskatchewan was a bitter fight, basically over money. Doctors wanted to maintain fee-for-practice, while the government wanted payment by salary. The public even got involved, similar to the way the Tea Baggers are now, organizing "Keep Our Doctors Committees":

In Regina, a group of mothers formed a committee to support their doctors. Similar committees were organized throughout the province, encouraged by doctors and joined by political opponents of the government. These KOD (Keep Our Doctors) Committees, with support from the media, launched a well-organized campaign against the government and the medicare plan. Rallies, petitions, panels and advertisements raised the emotional climate to a white heat.

On 1 July 1962, when the Act came into force, most doctors closed their offices, some took holidays or educational leave, while some staffed emergency centres. A few left the province for good. The Medical Care Insurance Commission 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. Lord Taylor, a physician who had been active in introducing Britain's health-care scheme, was brought to Saskatchewan by the government. He acted as mediator and the 2 sides signed an agreement in Saskatoon 23 July 1962. Source

At this point notice two key things: 1) the doctors were not in support of the plan, unlike the majority of doctors today, and 2) it was not universal, it was only implemented in one province and fully funded by that province.

Now keep in mind Senator Cantwells' amendment to allow a Medicare-type program with states option, where those states that want it can get it (with federal funding help) and those who don't want it have that choice.

My guess is that about 40 states will buy-in. And the rest will follow in the next few years.

OK--just got the call I've been waiting for and have to head to a meeting over my new office. Be back soon.

Originally posted to bewert on Mon Oct 05, 2009 at 11:43 AM PDT.


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