Public health care, or Medicare, in Canada is a relatively new phenomenon. It was founded on the principles that a health care system should be publicly administered, comprehensive, universal, portable and accessible to all Canadians.
This universal coverage is provided to all Canadians by their provincial health insurance plans. The costs are shared between the provincial and territorial governments and their federal counterpart.
The stage for a publicly funded health care system in Canada was set at the end of the Second World War and realized in 1966 (a period spanning some 20 years) with the implementation of the Medical Care Act. Prior to the creation of a public national health care system, the Canadian federal government, being weary of the political and financial ramifications of a full-scale socialized system, delayed its rollout.
The public health care system’s history can be traced back to Saskatchewan and its then premier, Tommy Douglas. Under his leadership, Saskatchewan introduced the Saskatchewan Hospitalization Act in 1947. This legislation established the foundation of creating public health care in the province and the country.
Tommy Douglas’s driving force in creating such a system was his belief that finances should not be an obstacle to accessing health services. Other provinces followed suit in the coming years, introducing similar proposals for a publicly funded health care system. By 1957, the Federal government had enacted the Hospital Insurance and Diagnostic Services Act to provide funding to provinces to cover specified hospital and diagnostic services.
By the end of the 1960s, what was once argued as a distant possibility had become reality. Through a collaborative effort, the federal government worked with all provinces and various organizations to establish a public health insurance system. In a progression of steps that spanned more than 20 years, the blueprints of a financially sustainable and universally accessible system were established.
Over time, the Canada Health Act was created to replace older legislation and reaffirm the principles of Medicare. The Act’s principles represent the requirements for a nationally funded public health care system and reflect the values of Canadians.
The history of the foundation of Medicare is one of a long struggle. Medicare was created by avoiding financial insolvency, appeasing opposing interests, countless compromises, respecting public opinion for a single-payer insurance plan, and manoeuvring through political jurisdictions and boundaries.
Public health care was created at a time in history when both the public and providers united to provide a single payer system to all Canadians. Its fundamental principles, basic framework of organization, and financing have remained the same over time. Remarkably, this health care system, developed over the past 40 years, has responded both to significant changes, including external pressures for privatization, and to the changing needs and possibilities of health care services themselves.
Currently, the system is facing a crisis in public confidence over its financial sustainability and service delivery. Declining federal health care transfers and decreased provincial spending have placed additional burdens on the public system.
Opponents continue to argue that a publicly funded health care system is not financially feasible and that a two-tier private undertaking should be established to better meet the needs of individuals. Others disagree, arguing that a publicly funded health system with a single payer has proven to be cost-efficient and has allowed Canada’s health outcomes to be among the world’s best. Moreover, some believe that the current Medicare system is envied and admired worldwide as well as being relied upon by Canadians.
Medicare was founded on the ideas of inclusion, equality, universality, accessibility, and the goal that financial barriers would not be an obstacle to medical care. It represents a distinctive Canadian example of nationalism and social justice, and some in this country consider Medicare to be the most valued and important social program in Canada today.