Health Care By: Christopher Moore

The historian Michael Bliss writes that as religious faith declined in the twentieth century, the life expectancy of Canadians also declined: from eternity to a hundred years or less. Is that why we now make a "sacred trust" of the public health care system which has become our chief protection against our fears of disease, incapacity… and death?

Until the 1950s, Canadians got medical treatment with cold cash, private insurance, or charity. In the prosperous 1950s and 1960s, Canadians who had endured the grim 1930s and the wartime sacrifices of the 1940s, developed both the mood and the means for what they came to call "the social safety net". That meant better public services, old age pensions, unemployment insurance, legal aid, union bargaining rights… and universal medical coverage.

Two politicians and a judge stand out in the making of Medicare. In 1962, Saskatchewan premier Tommy Douglas introduced Canada's first universal medical-care insurance program. Judge Emmett Hall, also from Saskatchewan, led the Royal Commission (1964–5) that charted a plan for nationwide Medicare. And it was prime minister Lester B. Pearson's government that negotiated federal-provincial agreements and saw the legislation passed—in a minority Parliament—which led to Canada-wide Medicare in 1966.

Health care is still a provincial responsibility. It is the provinces that provide medical facilities and run the insurance programs that pay for medical care. In exchange for financial contributions, the federal government requires that each province's medical care meet uniform tests for availability, universality, comprehensiveness, portability, and administrative efficiency.

Canadians' ever-growing appetite for medical services creates problems of rising costs, rationing of services, and individuals wishing to "opt-out." Governments and the courts struggle endlessly to square the circle: to design a system that will be unlimited yet affordable, and still respect individual rights. Yet, as much as we argue about Medicare, it has taken less than fifty years for most Canadians to see it as one of the fundamental benefits of being Canadian.