It was struggle that created medicare

By Shawn Whitney
Socialist Worker
1999

SHAWN WHITNEY examines the roots of how our medicare system was won. He argues that it was struggle which created a decent healthcare system, and that only struggle will defend what we have today.

The achievement of medicare was the product of decades of struggles involving thousands of people.

In 1915 in the United States, the growing demands for medicare on both sides of the border found expression in a campaign by unions and supportive medical professionals. This campaign sparked a huge national debate over the issue. In the heat of the post-World War One upsurge, Mackenzie King promised on the 1919 campaign trail to institute a national health insurance program.

After his election however, the union movement went into decline as employers won most battles throughout the 1920s. With the pressure off, and with doctors lobbying hard against any health insurance, King simply forgot about his promise. Like the resurgence of the issue of unemployment insurance, medicare again became a key issue in the 1930s as the struggle revived. This growth in struggle was also reflected in the growth of support for the Cooperative Commonwealth Federation (CCF), founded in 1935 -- the precursor of today's NDP.

The CCF supported a comprehensive health insurance scheme. Faced with the threat of CCF growth in British Columbia (where it had received one-third of the vote), the Liberal government passed health insurance legislation in 1936. But this legislation, and similar legislation passed in Alberta in 1937, was scuttled by the opposition of doctors and business groups.

Even though these first initiatives failed, they showed the momentum and support behind the idea. In 1936 Dr. Norman Bethune, a well known Communist, founded an organization called the Montreal Group for the Security of People's Health. This group involved Communists, CCF-ers and other progressives. According to Bethune, the "people are ready for socialized medicine." He also noted that most doctors were "enemies of the people and make no mistake, they are enemies of medicine too." The protests organized by Bethune's and other groups across the country pushed some provinces and numerous municipalities to fund limited medical and hospital coverage for those on relief and the unemployed.

All these initial steps took place long before the CCF government in Saskatchewan began to implement lements of medicare in the late 1940s early 1950s. During the 1950s, union members were also winning medical benefits through their contracts.

But the key battle came in Saskatchewan in 1962.

Under pressure from the party membership to live up to its program, the CCF government finally decided to bring in a fully-funded, comprehensive health program. This measure would have faced the same fate as the earlier attempts in BC and Alberta if it weren't for the unions mobilizing to defend the reform. On the day the legislation was passed, doctors across the province began an all-out strike.

As the Saskatchewan Federation of Labour put it: "Trade unions have fought for people and social justice, not against people and social justice, as these doctors did." To counter the strike, the trade union movement, farmers' groups and the cooperative movement set up thirty community health clinics. They worked with Saskatchewan doctors who supported the reforms and brought in others from around the country.

The doctors' strike collapsed after three weeks.

Saskatchewan medicare was so popular across the country that the federal government was forced to implement the similar Medical Care Act in 1966.

We need to learn the lessons from this for the battles to come in the future.

Decades of struggle by working people kept the issue of medicare alive. Decades of struggle by unions led to the creation of a party based on the working class (the CCF/NDP) which gave medicare its first legislative framework.

But when that was attacked by the right wing, the whole thing would have collapsed if it weren't for the thousands of workers and farmers who were willing to set up their own clinics. We will need this type of activism and mass mobilization to preserve medicare in the coming years.