A Canadian doctor examines the corpse of socialized medicine
For centuries, health care was, for the most part, provided privately by independent physicians. But during the Western collectivist moment of the 20th century, medical care became a common priority for reform in liberal and socialist governments.
One of the first models of modern health care systems dates back to Otto von Bismarck’s compulsory health insurance, introduced in the German Empire in 1884. The British National Insurance Act of 1911 was the first step towards universal health care within the British Empire.
Socialized medicine arrived in Canada after the Second World War. In 1947, the Government of Saskatchewan implemented a universal provincial hospital care plan and other provinces soon followed suit.
In 1966, over the objections of many medical practitioners, the Canadian government passed the Medical Care Act. In a short time, all provinces and territories moved to universal health insurance plans.
In the late 1960s and 1970s, this was considered one of the greatest blessings of our time. Today, the system is increasingly seen as an unsustainable curse.
Despite the promise of free universal care, Canadians began to ask themselves: why do so many citizens not have access to a family doctor? Why are aging Canadians waiting so long for specialized care or necessary surgery? Why do we hear horror stories about hospital room shortages and hallway medicine, and why is the system constantly running out of money?
Canadians never know how much of their taxes go to health care.
An insightful look at failing vision
Ontario physician Shawn Whatley’s recent book offers an insightful examination of Canada’s transition to socialized medicine.
Dr. Whatley, former president of the Ontario Medical Association, raises serious issues that concern millions of Canadians. He argues that health care won’t improve until we figure out how and why the system is failing so many patients.
The title of Whatley’s book is unambiguous: “When Politics Comes Before Patients: Why and How Canadian Medicare is Failing.” Why, he asks, are politicians and opinion makers trapped by a vision that does not deliver what it promises but prohibits criticism?
In the early stages of Medicare’s development, academics and progressive politicians mistakenly assumed that ordinary Canadians were being denied affordable medical care by greedy, profit-seeking physicians. Whatley says the left saw Medicare as another way to achieve social equity. For socialists, almost all supply difficulties are considered a market failure. Free health care for all, they insisted, must be part of Canada’s grand national vision.
Whatley examines the inevitable flaws in the socialist worldview that lead to the collapse of universal care. Like most social engineering experiments, he says the result is “inequality, less access, less efficiency, and more waste, including wasting the motivation and talents of doctors and nurses.” The late John Robarts, premier of Ontario from 1961 to 1971, described the emerging system as “one of the greatest political frauds ever perpetrated against the people of this country.”
During the Medicare salad days, between 1968 and 1977, everything from trivial complaints to traumatic injuries or illnesses were paid for with no questions asked. But, as Margaret Thatcher used to say, nanny state governments eventually run out of other people’s money. In Canada today, centralized management, bureaucratic miscalculations, years of cutbacks and political wrangling have left physicians and patients with little say in how health care dollars are allocated and spent.
Citizens with treatable knee and hip conditions suffer for months, sometimes years. In some localities, seeing a dermatologist can take up to eight months. Whatley points out that waiting lists are the norm rather than the exception. Healthcare professionals and hospital managers have come to accept this as essential triage. Whatley says Canada is effectively rationing care by cutting technology, hospital beds and staff.
Defining Myths and the Leg of Tommy Douglas
Grand narratives, Dr. Whatley says, always need a defining myth, a story to capture the essence of a larger vision.
In the case of Canada, it was the incredible story of the infection in the leg of the late Premier of Saskatchewan, Tommy Douglas. According to Whatley, the story contained everything: “the pain of the conflict, the victims and the villains”.
At the age of 6, young Tommy fell and scraped his knee in Falkirk, Scotland. The wound became infected and invaded the bone. After several surgeries, the boy narrowly avoided amputation. He eventually recovered with the help of a famous Winnipeg surgeon who offered to operate for free. The doctor only asked that his medical students be allowed to observe and learn from the operation.
Douglas grew to become the leader of the Canadian Commonwealth Federation. In 1944, he formed the first socialist government in North America. Shortly after his election, he invited a John Hopkin professor, Henry E. Sigerist, to investigate health care needs in Saskatchewan. Sigerist was a recognized expert on the healthcare system in the Soviet Union.
Douglas refused to let his childhood medical crisis go to waste. He encouraged parents to imagine themselves without sufficient funds to pay for a child’s operation. He used his childhood trauma and leveraged the charitable care he received to fuel his campaign for socialized medicine.
Presented as a call for compassion and the utopian belief that health services “should be priceless”, Douglas accused the medical profession of “so cruel and corrupt that we should marvel that it could have existed in a democratic society”.
The overlapping charges implied that only the wealthy could afford good care. No one thought to question him, Whatley said. But the truth was quite different. “For three thousand years,” he wrote, “medicine survived by treating people first and accepting payment later.”
In interviews with several physicians who had practiced in the 1950s and 1960s, Whatley asked: Were patients who couldn’t pay denied care before Medicare? Every doctor he spoke with confirmed “with passion and dignified indignation” that all patients received excellent care, regardless of their ability to pay, in the same way Tommy Douglas himself did.
Many low-income, working-class families, including my own, who lived through the period before socialized medicine also remember the family physicians who regularly visited our homes.
Adopting “conventional wisdom”
In the second chapter of his 1958 book “The Affluent Society”, the late economist John Kenneth Galbraith argued that long-established views present obstacles to new thought and human progress.
For the intelligent, Canadian-born Harvard professor, our ability to satisfy genuine human needs and protect vital public interests was hampered by a “conventional wisdom” that falsely celebrated the material productivity and superfluous “wealth” of American capitalism.
Beginning in the 1960s, Galbraith’s humor captured the imagination of progressive North American policymakers. It became widely accepted that the realities of our time called for mixed economies and more government services.
But by the time Galbraith wrote “The Affluent Society,” his philosophical opponents were mostly imaginary. Since FDR’s New Deal, the managerial imperative to regulate free markets had become central to the thinking of academics and politicians across the West. For Western progressives, public approval has always trumped the search for truth; and intellectuals like Galbraith were master interpreters.
Too often, Whatley argues, cynical forms of anti-Americanism and anti-capitalism are invoked to silence critics of Canadian Medicare. For progressives, the idea of free health care has become the quintessential Canadian value. It is a defining myth that strives to satisfy the collectivist spirit of the nation.
But medical care doesn’t thrive in a political science lab, he says. Patients must be allowed to re-establish a connection with their physicians that transcends episodes of government-provided services. Interacting with interchangeable state-mandated providers will never promote excellence in care.
Whatley’s review of Medicare takes thoughtful readers on a road less travelled. He argues that the heavy hand of ideology prevents Canadians from questioning a deeply flawed status quo. “We are,” he writes, “stuck in a worldview that invites panic and outrage if anyone questions it.”
Challenging conventional wisdom requires commitment, courage, imagination, knowledge and a dedication to truth. Whatley offers all of the above in “Politics Before Patients”.
The opinions expressed in this article are the opinions of the author and do not necessarily reflect the opinions of The Epoch Times.