 Saskatchewan
and Alberta were inaugurated as provinces just days
apart in 1905 and both provinces are gearing up for
centennial celebrations this year. The two western provinces
started off their Canadian presences similarly —
as hulking, mostly rural former pieces of the Northwest
Territories. They even had like political landscapes
early on with the Liberals dominating. But after the
Great Depression, Saskatchewan and Alberta would take
markedly different paths shaped by the long reigns of
the socialist Cooperative Commonwealth Federation (CCF)
in the former and the right-leaning Social Credit Party
in the latter. In this first of a two part series, we
look at Saskatchewan, its healthcare, and its key role
in the development of medicare.
MAN
WITH A HOSPITAL PLAN
The election of recent 'Greatest Canadian' victor Tommy
Douglas and the CCF in 1944 was a turning point not
only in Saskatchewan, but also the whole nation's history.
It was the first socialist government ever to be formed
in North America. Fear was rife, and the news was splashed
all over the front pages of Canadian and US newspapers.
But fortunately none of the fears and predictions of
Premier Douglas's political opposition came to pass:
there was no Stalin-esque forced farm collectivization,
nor did it prove true that "the CCF socialists will
use democracy to get into power, but will scrap it as
soon as they get into office," as a typically blustery
pre-election Regina Leader-Post editorial trumpeted.
What did happen was some much-needed
house cleaning. During his first term in office Premier
Douglas set upon the ho-hum task of reducing the province's
debt. Then, in 1947, the CCF took a baby step toward
realizing its medicare dream by introducing a universally
affordable government hospitalization insurance plan.
By 1956, the federal government was encouraging all
the provinces to follow Saskatchewan's lead by agreeing
to foot their own health insurance bills.
Premier Douglas did a good job
selling the merits of universal state health insurance
to the people of Saskatchewan. Indeed, the pitch was
so good that the opposition Liberal party eventual adopted
its own, remarkably similar, plan. It was all for nought,
as Tommy Douglas went on to win the so-called 'medicare'
provincial election of 1960 (he resigned a year later
to enter the federal fray, and Woodrow Lloyd became
premier). But it was really a battle to decide who would
implement the expansion health services. The Liberals
said they would let the people decide by plebiscite
if they wanted medicare but the popular plan certainly
would have passed. The only major party that dared attack
the idea of medicare was the then-unelectable Social
Credit.
ALL
ABOARD, EXCEPT...
For all its popular support, the CCF's medicare plan
didn't exactly set Saskatchewan physicians' hearts aflutter.
Dr Ernie Baergen, a retired family physician and long-serving
head of the Saskatchewan Medical Association (SMA),
was a primary witness of the medicare plan's severe
growing pains. He was one of the new University of Saskatchewan
College of Medicine's first graduates in 1957, and his
earliest years of practice were coloured by battles
with the government over medicare.
"The general point of resistance
to the plan came down to the fact that the government
was not being completely up front with us," he explains.
"Premier Douglas initially promised that the medicare
act would be satisfactory to both providers and recipients."
The Canadian Medical Association
ran a campaign against the CCF medicare plan casting
it as 'socialized medicine' and generally insinuating
it would send medicine back to the dark ages. This,
in hindsight, was an enormous tactical error. Its obvious
hyperbole made doctors look greedy when that certainly
wasn't the case. "The medicare act took away the worry
about paying the bills — at the time we had information
that about a third of the population wasn't covered
and that was the appeal of the plan," says Dr Baegan.
"It was as much the way medicare was introduced
as what was introduced that upset doctors."
STRIKE
WHILE SUMMER'S HOT
In the summer of 1962 Saskatchewan's physicians decided
enough was enough and walked out. Their strike and its
resolution were instrumental in shaping how medicine
is practised in this country today. When the victorious
CCF enacted the Saskatchewan Medical Care Insurance
Plan the province's doctors felt compelled they had
no other choice. "Part of the resistance was that we
wanted no part of negotiating our fees," says Dr Baergen.
"It was some years later that a mechanism was developed
for negotiating fees."
The two-week strike provided Saskatchewan's
MDs little opportunity for enjoying long prairie summer
days. Dr Baergen was working in the Saskatoon City Hospital
ED at the time. "I was never so tired in my life, but
not from the volume of people, but by the uncertainty
of the situation," he says, adding that he had to take
some time off afterward to recuperate from the stress.
In the end, British politician,
former practising physician and Lancet editor
Lord Taylor was drafted in to negotiate an end to the
strike. As part of the settlement doctors maintained
the right to bill for extra services.
The public, on the whole, were
none too pleased with either the government or the doctors
over the strike fiasco. The next time Saskatchewanians
went to the polls — on May 2nd, 1964 — they
turfed the CCF out of office in favour of the Liberals.
But by then medicare was firmly entrenched in Saskatchewan,
and Prime Minister Lester B Pearson promised to bring
universal coverage to the rest of Canadians.
Dr Baergen, who still lives in
Saskatoon, continues to look back in anger at the early
days of medicare. "Prior to this I had no interest in
partisan politics. It became law and if you wanted to
practise you had to respect the law," he says. "When
all you get to eat is oats you eat oatmeal."
Nowadays, the CCF's heirs, the
NDP, are in power in Saskatchewan once more, so its
pretty safe to assume medicare in the 'wheat province'
isn't going anywhere anytime soon.
Next issue: NRM takes a historical
look at medicine in fellow centenarian province, Alberta.
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