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Steps on the Road to Medicare: Why Saskatchewan Led the Way

C. Stuart Houston
Copyright Date: 2002
Pages: 176
https://www.jstor.org/stable/j.ctt816z3
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  • Book Info
    Steps on the Road to Medicare
    Book Description:

    Among Saskatchewan's many firsts were the payment of municipal doctors, the development of municipal hospitals, and advances in the treatment and prevention of tuberculosis - then the leading cause of death - that culminated in January 1929 with universal free diagnosis and treatment of TB. Given this background of leadership, it was logical for North America's first social democratic government, the CCF, led by Tommy Douglas, to go further, beginning with medical care for pensioners and widows. This was quickly followed by a universal, comprehensive health care plan, instituted in the Swift Current region in July 1945, two years before Britain began such a program. Universal, province-wide hospitalization insurance was put in place in January 1946. Advances in psychiatry consisted of the first inclusion of psychotic patients in an open psychiatric ward in a general teaching hospital in 1955, while cancer firsts included the first government-sponsored cancer clinics, the first full-time cancer physicist, and the world's first use of calibrated betatron and cobalt-60 machines for treating cancer. Why was Saskatchewan so consistently first in health care? Houston argues that not only was the population both altruistic and ingenious with a well-developed spirit of co-operation but that its leaders, including Maurice Seymour, R.G. Ferguson, Harold Johns, and Tommy Douglas, showed unusual foresight. He details how from 1915 through 1962 government responded quickly to public need and suggests that it should be equally responsive today.

    eISBN: 978-0-7735-7022-1
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. ABBREVIATIONS
    (pp. vii-viii)
  4. ACKNOWLEDGMENTS
    (pp. ix-x)
  5. FOREWORD
    (pp. xi-2)
    Sylvia O. Fedoruk

    Saskatchewan has been a leader in many aspects of health care. These developments arose from the co-operation and mutual help necessary among pioneer settlers‚ sparsely distributed in a relatively hostile environment. House-raising‚ barn–raising and the building of community amenities such as schools and curling rinks made it logical for other cooperative developments also to occur.

    These accomplishments took place in an atmosphere of community‚ creativity‚ and trust. Individuals with foresight such as Drs Seymour‚ Ferguson‚ Blair and Johns helped Saskatchewan to lead the world. InSteps on the Road to Medicare: Why Saskatchewan Led,Stuart Houston reviews many of...

  6. INTRODUCTION
    (pp. 3-7)

    “Medicare is considered to be the most valued social programme in Canada today. Canadians have rated it as their most important concern‚ ahead of programmes in employment and social welfare ... medicare is an essential part of Canada’s national identity and part ... of what it means to be Canadian.”¹

    Most of the steps that led to medicare were forged in Saskatchewan. The events described in this book changed the course of health care throughout Canada.

    There is a certain danger in listing all the times Saskatchewan was “first‚” leaving me open to charges of hero-worship‚ bragging and jingoism. Yet...

  7. CHAPTER 1 SASKATCHEWAN HOSPITALS: Off to a Slow Start
    (pp. 8-20)

    To maintain a little balance in an unabashed book of firsts‚ it seems only fair to admit that the area that became Saskatchewan in 1905 was slow off the mark – the advent of hospitals was delayed in comparison with adjacent Manitoba and Alberta.

    Strangely‚ the first hospital established in what is now Saskatchewan was in one of the most inaccessible parts of the province‚ at Ile-à-la-Crosse. Three dedicated Sisters of Charity (Grey Nuns)‚ Sisters Agnes‚ Boucher‚ and Pépin‚ arrived there in 1860 with Bishop Grandin after an arduous journey of fifty–seven days in an open barge from St Boniface....

  8. CHAPTER 2 DR SEYMOUR
    (pp. 21-27)

    Maurice M. Seymour is the pacesetter in our story. Born 7 July 1857‚ in Goderich‚ Ontario‚ Seymour was one of three children of Captain Maurice Bain Seymour‚ who hailed from Ireland‚ and Maria MacDonald‚ who came from Scotland. He began his studies at Assumption College‚ Windsor‚ Ontario‚ in 1873 and then obtained his medical degree from McGill University in 1879. Rather unusually for those times‚ he took two years of post-graduate study before he went into practice.¹

    After employment with the Canadian Pacific Railway during its construction in 1881–83 and service in the Riel Rebellion in 1885‚ Seymour practised...

  9. CHAPTER 3 MUNICIPAL DOCTORS AND MUNICIPAL HOSPITALS
    (pp. 28-40)

    One major step on the road to medicare occurred in the RM of Sarnia. The Holdfast history book‚History and Heritage,quotes the motion passed by the council of the Rural Municipality of Sarnia #2.2.1 in January 1914: “That Council advertise for a doctor ... Also first correspond with Dr Schmitt of Newton‚ Illinois‚ in regard to locating here.” Perhaps Schmitt wrote to Holdfast in response to advertisements which talked of “The Last Great West” and the “Beautiful Last Mountain Valley where crop failures are unknown‚”¹ or the contact may have been made by a farmer who had moved from...

  10. CHAPTER 4 DR FERGUSON AND TUBERCULOSIS
    (pp. 41-68)

    In fighting the disease that for many years took the greatest toll on health and productivity‚ Robert George Ferguson was one of the most consistent and effective leaders in North America. Sixth in a family of sixteen‚ he was born on 12 September 1883 near the Red River at Joliette‚ North Dakota‚ only seventeen miles south of the forty-ninth parallel. At age nineteen he was delegated by his family to choose a farm in Saskatchewan‚ of similar size to the one being vacated in North Dakota. He selected one at the south edge of Yorkton and moved his parents‚ brothers‚...

  11. CHAPTER 5 SIGERIST AND PENSIONERS’ CARE
    (pp. 69-76)

    “No person has had as profound an effect on the restructuring of health services in Canada as Tommy Douglas‚ that doughty little Scottish socialist fighter and orator”¹ (Figure 5–1). Douglas was “among the greatest political campaigners Canada has known.”² His CCF party won a landslide victory‚ forty-three of the fifty-two seats‚ in the Saskatchewan election of 15 June 1944. Health was Tommy’s number one priority then and throughout his tenure as premier.³ To be certain that health matters were front and centre‚ Douglas assumed the health portfolio himself.⁴ For his first four-year term of office and into his second...

  12. CHAPTER 6 SWIFT CURRENT HEALTH REGION
    (pp. 77-88)

    Joan Feather opens her two landmark articles on the history of the Swift Current Health Region with the following statement:

    Southwestern Saskatchewan seems an unlikely place for a major experiment in universal, prepaid health services. Rolling grassland, short, hardy crops struggling against drought and wind, vast expanses without signs of human dwelling – how can such a place give rise to a sophisticated service structure? The explanation is to be found in the unique combination of past experience, local leadership, and government policy, skilfully merged into an experiment with remarkable staying power.¹ Past experience and local leadership were exemplified especially by...

  13. CHAPTER 7 MEDICAL COLLEGE AND UNIVERSITY HOSPITAL
    (pp. 89-91)

    The success of any future medicare program in Saskatcwan required a first-rate medical school. Sigerist’s report in 1944 recommended construction of a full, five-year medical school¹ and a 500-bed university hospital in Saskatoon. Sigerist predicted the building and equipping of the hospital and medical school would cost $2 million,² with annual operating costs of $150,000.

    Even before the 1944 election, T.C. Douglas planned a medical college when he took power. In thinking of possible candidates for a dean of medicine, he took advice from Dr W.C. Gibson, then serving at the Royal Canadian Air Force Clinical Investigation unit in Regina.³...

  14. CHAPTER 8 PROVINCE-WIDE HOSPITALIZATION
    (pp. 92-97)

    Saskatchewan took Sigerist’s advice to heart in becoming the first province to provide funds for capital construction of hospitals, a major step on the road to medicare.¹ Between 16 March 1945 and 1 March 1949, the government provided $653,714 in outright construction grants and $173,500 in loans.² The National Health Grants Programme in 1948 added substantial federal funds to support hospital construction; Saskatchewan, sadly, having been too quick off the mark, was ineligible for matching federal funds for new construction since most of its hospitals had already been built. The province was in double jeopardy because some of the operational...

  15. CHAPTER 9 INNOVATIONS IN PSYCHIATRY
    (pp. 98-104)

    When Saskatchewan became a province in 1905, psychiatry and mental hospitals across Canada were in a backwater compared to the rest of medicine. The first opportunity to show leadership was scuttled by unfortunate advice from Ontario.

    Dr David Low of Regina, the provincial health officer (Figure 9-1), was sent in 1907 to visit mental hospitals in eastern Canada and the United States. He was asked to consult widely and to make recommendations for construction of a mental hospital in the new province. He visited two up-to-date mental hospitals in New York State, at Ogdensburg and Ward Island, and the Protestant...

  16. CHAPTER 10 HIGH-VOLTAGE CANCER TREATMENT
    (pp. 105-123)

    Saskatchewan was slow off the mark in using radiation to treat cancer but, once up to speed, it led the world. As with the initial provision of radium in 1932, high-voltage treatment could be available only with government support.

    In 1922, Dr Ellice McDonald,¹ a Saskatchewan man who had been raised at Fort Qu’Appelle² and later specialized in cancer research at the University of Pennsylvania, visited University of Saskatchewan president Dr Walter Murray. McDonald informed Murray that the province of Quebec had just purchased a gram of radium for $75,000 and suggested that Saskatchewan should take similar action. In response,...

  17. EPILOGUE
    (pp. 124-128)

    Medicare became law in Saskatchewan on 1 July 1962. However‚ with inadequate communication and bad timing on both sides‚ confrontation led to an action not contemplated by the government: withdrawal of services by the great majority of doctors. Each side‚ government and medical profession‚ “was convinced of the legitimacy of its role‚ the tightness of its goals‚ and of its power to achieve them.”¹ Under the distinguished arbitration of Lord Stephen Taylor‚ a socialist and a medical doctor‚ who shuttled back and forth between the government and representatives of the Saskatchewan College of Physicians and Surgeons‚ and earned the trust...

  18. NOTES
    (pp. 129-154)
  19. INDEX
    (pp. 155-163)