Comprehensive health care still lacking in Canada

Jimmy Kimmel deplores “pay-or-die” health care system in U.S., but coverage in Canada lacking, too.

“Courage, my friends, it is not too late to build a better world.”
 –Inscription on Tommy Douglas’s tombstone.

When ABC talk show host Jimmy Kimmel recently told his TV viewers about his newborn son’s open-heart surgery, he deplored the inequity that tarnishes health care in the United States.

He said he had ample money to pay the steep cost of the surgery, which could amount to $200,000 or more. But millions of low-income American families, he pointed out, would have been forced to let their newborn child die.

“If your baby doesn’t have to die, it shouldn’t matter how much money you make,” he argued, “whether you’re a Republican or a Democrat, or something else. We all agree on that, right?”   

Unfortunately, there is no such consensus in the U.S. Even as Kimmel was speaking, the reigning Republicans were making another attempt to ram through a health care reform bill that would not only perpetuate this “pay-or-die” approach, but worsen it.

Kimmel could have reminded his audience that the United States is the only advanced country that lacks a national public health care system, and that in other developed countries, including Canada, surgeries of this kind are performed with no cost to the parents.

Kimmel’s experience parallels that of the parents of Tommy Douglas, now revered as the “father of public health care” in Canada. They emigrated to Canada from Scotland in 1910, when Tommy was six years old.

He had fallen and severely hurt his left knee in Scotland, and the injury led to the onset of osteomyelitis, a serious bone disease. The disease flared up shortly after the family settled in Winnipeg. His father, an iron moulder, couldn’t afford the cost of a bone specialist, so he was admitted to a Winnipeg hospital as a charity patient.

The doctors told his father (also named Thomas) that, without remedial surgery, their only option was to amputate Tommy’s leg.

Fortunately, there was an orthopedic surgeon at the hospital who was looking for a patient he could use in his teaching classes. After examining Tommy’s swollen knee, he told his parents he could save the leg if they would permit him to use the boy to help him teach his medical students. Of course, they readily agreed. The surgery was a success and Tommy escaped the planned amputation.

“Had I been a rich man’s son instead of the son of an iron moulder,” he later recalled, “I would have had the services of the finest surgeon and wouldn’t have had to depend on chance for a cure. Through all my subsequent adult life, I dreamed of the day when an experience like mine would be impossible and we would have in Canada a program of medical care without a price tag.”

From dream to reality

He took that dream with him into the Saskatchewan legislature when he first became premier in 1944. “Why should anyone be denied health care because of an inability to pay?” he kept asking the MLAs. “Why should it not be a basic and universal right of citizenship?”

An important first step toward that goal was made in 1947 with the passage of a provincial public hospital insurance plan, but it wasn’t until November 1961 that the CCF government felt confident enough to table the full-fledged Saskatchewan Medical Care Insurance Act.

Passage of the bill, however, was far from an easy accomplishment. It ignited a firestorm of condemnation and controversy that raged for months.

Joe Fafard's sculpture of Tommy Douglas at the Museum of Civilization. Photo by Trevor / Flickr.
Tommy Douglas “considered medical and hospital care just the first steps toward instituting the broad comprehensive care achieved in Europe,” writes Ed Finn. Photo by Trevor / Flickr.

The anti-medicare forces included both the Liberal and Conservative parties, the Canadian Medical Association, nearly all the province’s newspapers and radio stations, and the Chamber of Commerce and other major business organizations. About 600 of the province’s 920 doctors actively campaigned against public health care.

Despite this onslaught of opposition, the first public health care program in Canada was legislated in Saskatchewan in July 1962.

Over the next five years the program was gradually adopted by all the provinces, and it culminated in a national health care system in 1984 when the federal government passed the Canada Health Act.

considered medical and hospital care just the first steps toward instituting the broad comprehensive care achieved in Europe.

Not many Canadians are aware that the Canadian Medical Association, which made every effort to block public health care in 1962, elevated Tommy Douglas to its Hall of Fame in October 1998. He is the only non-physician to be so honoured. In giving him this posthumous citation (Tommy had died 13 years earlier), the doctors were admitting publicly that they had been wrong in 1962.

The CMA plaque acclaims Tommy as “the Father of Canadian Health Care” who “envisioned, built, and tirelessly promoted our national system of health care. His leadership has provided long-term benefits to medical science in Canada, and a Canadian health care system that is a source of envy to other countries.”

Comprehensive care lacking

That last sentence, however, is not factual. No doubt medicare in Canada is a source of envy to Jimmy Kimmel and many other Americans. But the health care systems in most other developed countries are far superior to Canada’s.

In this country coverage is confined to the services of doctors and hospitals. In most European countries the service also covers pharmaceutical, dental, vision, and other health requirements.

Tommy Douglas also envisioned such a complete health care program for Canada. He considered medical and hospital care just the first steps toward instituting the broad comprehensive care achieved in Europe.

But, despite his valiant later efforts and those of other health care advocates since 1962, our system still lags far behind those in other countries, except the United States.

Pull Quote Ed Finn Canada Health CareWe live in a country where as many as one in five households often can’t afford to fill their medical prescriptions; where many thousands of families can’t afford dental and vision care for their children; where many thousands of children in poverty-stricken homes lack the nutrition and care needed for optimum health.

The resistance to expanding medicare in Canada to the all-inclusive level attained in other countries is not as fierce and formidable as was the opposition to its introduction in a limited form in Saskatchewan 55 years ago.

But the current foes of comprehensive coverage are no less determined to block it. The principal weapon in their propaganda arsenal is the claim that the provision of pharmacare alone would be too costly, and the addition of dental and vision care even farther beyond the limits of affordability.

To which the obvious rebuttal is: If so many other countries could afford full-fledged health care, why is it impossible for Canada to do so?

Many studies have been done by health care experts establishing that, far from being too expensive, comprehensive health care is just as achievable in this country as it was in England, France, Germany, Sweden, Norway, Denmark, and many other countries. It will probably take several years to phase them all in, but it’s a project that could and should be a top priority for our federal and provincial governments.    

Until that endeavour is launched, we can share Jimmy Kimmel’s deep regret that people in the U.S. are forced to pay for basic health care needs or do without them. But we should also be aware of the huge holes that still remain in our own health care system – and join in a much-too-long-delayed campaign to have them filled.

(This article was originally published by on May 12, 2017 and republished here with the author’s permission.)

Ed Finn was editor at the CCPA Monitor for 20 years. Formerly, he was editor of the Western Star in Corner Brook, a reporter at The Montreal Gazette, and for 14 years wrote a column on labour relations for The Toronto Star. He also served for three decades as a communications officer for several labour organizations, including the Canadian Labour Congress and the Canadian Union of Public Employees.

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