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Politics trumps patient care when governments are failing
Much of medicare’s dysfunction comes from compromises made to win votes in moments of political weakness
Medicare emerged during failing and minority governments, much like the time we find ourselves in now. Three pillars of medicare legislation passed with near unanimous support during periods when the opposition could not risk debate.
The first pillar of medicare, the Hospital Insurance and Diagnostic Services Act (HIDSA), passed unanimously in 1957. The majority Liberals had been in power since 1935. HIDSA introduced dollar-for-dollar cost sharing between the federal government and the provinces. The Diefenbaker Progressive Conservatives offered unanimous support, and months later won an upset minority. In 1958, Diefenbaker won again — the largest majority in Canadian history, up to that point.
By 1963, voter sentiment had reversed, and voters had tired of Diefenbaker. The minority Liberals tabled the Medical Care Act. The MCA promised to expand Parliament’s 50:50 funding to include doctors’ services. Provinces needed to nationalize medical insurance and create publicly-funded, single-payer provincial insurance plans to qualify for federal funds. Parliament passed the Medical Care Act in 1966 by a vote of 177 to two. The two “nays” came from Social Credit MPs: Robert N. Thompson, from Alberta, and Howard Earl Johnston, British Columbia. The Liberals, Progressive Conservatives and NDP offered unanimous support. Pierre Elliott Trudeau won a majority in June 1968, and the MCA took effect weeks later on July 1.
Note: Shawn Whatley is a physician, a Munk Senior Fellow with the Macdonald-Laurier Institute and author of “When Politics Comes Before Patients: Why and How Canadian Medicare is Failing.”
