“Medicare” was never designed as a Canadian Health System. It emerged after World War II as an insurance program. It paid our bills when we went to the hospital (Hospital Insurance and Diagnostic Services Act:1957) and when we went to the doctor (Medical Care Act:1966). Combined, these two Acts created a nation-wide public
insurance program for hospital and physician compensation. At it’s time it was both a great leap forward for human services in Canada as well as a courageous Canadian political achievement. But it remained first and foremost an insurance payment system.
As our country grew and matured we did so with hospital and doctor insurance support, but without universal healthcare for all Canadians. Lacking a comprehensive primary care design as a robust immune system, our public health insurance, from the outset, was vulnerable to political attack: not fiscally sustainable; challenged by for-profit
opportunists; unresponsive to inequitable social and political structures. Attacks that unfairly blamed a “public” system while ignoring the failure over the past sixty years to redesign our system’s architecture to establish healthcare for all.
Could the politicians please answer me this? Why do we keep fighting the same old divisive political battles when we have a new model before our very eyes? For those seeking political leadership I would caution you to resist being lured into the stale framing of a for-profit private solution to a universal public priority. Citizens expect more
from you. Instead I would strongly urge political leaders of all stripes to endorse the primary care foundation envisioned by Dr. Jane Philpott in her 2024 book, Health for All. Her lucid and visionary call is for the establishment of a comprehensive primary care model to serve every Canadian. A design model which mandates a “healthcare home” for every citizen. Of course you will be challenged with the model’s affordability. But as Dr. Philpott clearly states, “There are immense downstream savings with universal access to primary care.”
Yes politicians, you will face fierce opposition to this visionary prescription:
Whether it be from the status quo eco system,
Or barriers to entry raised by special interest groups,
Or simply the absence of political backbone.
Nevertheless, this is long overdue for our country. We are not voting for miracles. We
are voting for your courage. Higher quality healthcare that’s fiscally sustainable – what
could be more of a priority in a new caring economy?