The five pillars of Medicare emerged from two laws: the 1957 Hospital
Insurance and Diagnostic Services Act along with the 1966 Medical Care
Act to form the basis of Medicare in Canada. These two laws, along with
later adjustments, merged into the 1984 Canada Health Act. Canadians
felt their medicare system was secure.
These five medicare principles form the basis of Canada’s public health
system and apply to all provinces and territories:
- Universality – Provinces cover 100 per cent of their residents for
hospital and physicians’ services. - Comprehensiveness – Provinces cover all medically necessary
services by doctors or within hospitals. (Community services such as
home care are not covered.) - Accessibility – Services are to be “reasonably accessible”. Financial
charges or other barriers do not impede accessibility. - Portability – Provincial insurance covers residents while in other
provinces. - Publicly Administered – Provincial governments must administer their
public health insurance program.
Most Canadians don’t remember what it was like before medicare…
because they weren’t born yet. Three quarters of Ontario’s current
population were born after medicare was introduced in 1966. I expect that
many Canadians think that we’ve always had medicare in this country. For
most people medicare is the way its always been and so we’ve come to
take medicare for granted, forgetting how hard a fight it was to achieve
and how fragile it remains. And how hard it’s going to be in keeping it.
I also took medicare for granted until a letter from a group of Stratford
women to the Ontario Premier in 2020 lit a fire under me. I had worked in
the Canadian health system for close to 50 years, all across Canada, and
not until I saw that letter (and tried to help get answers ) did I wake up to
how tenuous our Medicare system is in this county. And how under threat
it remains. Much of it because of the political tension between the
provinces/territories and the federal government, which plays out with
Canadians wondering, “What the hell’s going on?”
This topic will be continued…