Battle Over State Medicine Stirring Again In Canada

Press, Volume CI, Issue 29998, 6 December 1962, Page 24

Battle Over State Medicine Stirring Again In Canada

[Specially written for the N.ZP.A. by

MELVIN SUFFRIN

TORONTO, December 4.

Four months after the Saskatchewan doctors went on strike to protest against the provincial Government’s medical care insurance plan, Canada’s battleground for socialised medicine is stirring again*

Most of the 900 doctors in the prairie wheat-growing province halted practice for 23 days in July, leaving only a small number of physicians for emergency service as they fought for changes in the Government legislation. Their boycott ended with a compronuse agreement under which the doctors were given three choices. They could work within a medical care plan and be paid by the Government at the rate of 80 per cent of their fee scheduled. They could receive their payments from the Government indirectly by working through private insurance schemes. Or they could choose to work completely outside the insurance plan by collecting from those patients who agreed to pay fees out of their own pockets even though they were also required to contribute to Government insurance. Not So Sure At that time, the doctors -egarded these concessions as a victory. Now they are not so sure Some physicians have complained to the Socialist Premier, Mr Woodrow Lloyd, that steps are being taken to circumvent

this agreement. Specifically, they object to increasing the number of community health clinics in which groups of private individuals band together to hire their own doctor and provide equipment and office space for him. The point at issue is that the contract offered by these groups specifies that doctors must receive an annual salary regardless of how many patients they treat and must agree to work under the Government medical insurance. At present, eight of these clinics are in operation. Fifteen more are soon to go into operation and 22 others are in the planning stage. Sponsors of the clinics have formed a provincial association to promote their activities and they are able to exert considerable pressure, particularly in the small towns and the farm areas of the province of 900,000. Some doctors outside the clinics feel they represent a threat to their right to practise privately. It is significant that when the doctors’ strike ended, only 61 physicians were practising under the Government plan, which takes care of all medical bills for an annual insurance fee, although it also

draws on part of the provin- : cial sales tax for revenue. > At present, there are more f than 100 doctors under the ■ Government plan and the ■ number is growing. Some t physicians were imported from Britain to help with the t emergency during the strike t and a number of these have > remained, but there is a grow- ■ ing percentage of Canadian ' doctors joining the Governt ment scheme. The doctors say that if the clinics continue to grow, they i could eventually force all ■ physicians in rural areas to i work under the Government ‘ and they regard this as contrary to the agreement i The sponsors of the clin- . ics, on the other hand, com- • plain that their doctors often t have difficulty getting work- ■ ing privileges in privatelyi run hospitals. Throughout the strike the • doctors received support from ; the Liberal Party and its : leader, Mr Ross Thatcher. ■ Since then, however, the Liberals have come to accept the i medical insurance. They , evidently realise that while ■ many people in Saskatchewan t are bitter towards both the I Government and the doctors. I they nevertheless favour i medical insurance. The Liberals are given a good chance of taking power in the election, but they know they would endanger their chances of success if they were to take a strong stand against the principle of the medical plan. National Scheme Meanwhile, it is becoming obvious that within a few years there will be some sort of national medical insurance Shortly after the Second World War, Sackatchewan’s Socialist Government introduced Canada’s first hospital insurance legislation. In spite of initial opposition, it eventually was copied by other provinces and now has become national in scope with Federal Government participation. Now Ontario is laying plans for medical insurance and it is worth noting that Canada’s most populous province is governed by a Conservative Government. Ontario’s plan will not be as comprehensive as in Saskatchewan, nor will it be compulsory for all, and there will be nothing like the degree of Government control exercised in Saskatchewan; but it does mark the start of the spread of this form of insurance and it is becoming clear that if Saskatchewan doctors thought they were stemming the tide they were wrong.