http://www.slate.com/id/2245037/
Tea Party, Canada-Style!
America's battle over health care reform started in Saskatchewan.
By Christopher Flavelle
Posted Thursday, Feb. 18, 2010, at 6:51 AM ET
Nearly 50 years before Sarah Palin gave us "death panels," the
American Medical Association was testing the limits of health care
scare tactics in the Canadian prairies. During the 1960 provincial
election in Saskatchewan, the AMA helped fund an advertising campaign
aimed at defeating the Co-operative Commonwealth Federation, a
quasi-socialist party whose leader, a former Baptist minister named
Tommy Douglas, had promised to introduce universal, government-funded
health care in the province.
The AMA, together with Saskatchewan's College of Physicians and
Surgeons, warned that if the CCF won, doctors would leave the province
in droves. But here was the kicker: As Dave Margoshes writes in his
1999 biography of Douglas, the campaign told voters that if the state
were permitted to take over health care, "patients with
hard-to-diagnose problems would be shipped off to insane asylums by
bungling bureaucrats."
The campaign failed. Douglas won the election, and the CCF government
went on to introduce his health care plan in 1962, creating the model
that the rest of Canada would later follow. (So far as we know,
insane-asylum panels did not come to pass.) But the fight for health
care reform in Saskatchewan, which the AMA worried could spark change
in the United States, was a precursor to the battle in America todaya
mix of populist anger, political opportunism, and disinformation. As
Democrats debate whether to pursue health care reform in the face of
growing opposition, they might consider the lessons of Saskatchewan.
Like the Democrats after their 2008 victory, the CCF moved slowly at
first to implement its plan, a delay that emboldened the opposition.
In an attempt to win the support of doctors, the government created an
advisory panel for their concerns. Doctors used the panel to stall,
and the government waited more than a year to pass its reforms, with
the start date delayed until July 1, 1962. The province's doctors
responded with a vote to strike if the plan was implemented.
The events of the next 10 months were ugly by Canadian standards.
Douglas' push for health care reform "lit the fuse of the incendiary
bomb that would tear Saskatchewan apart into its two opposing
elements," wrote Doris French Shackleton in her 1975 biography of
Douglas.
Part of the unrest came from doctors themselves. In the months leading
up to the new plan, physicians across Saskatchewan put up office signs
reading, "Unless agreement is reached between the present government
and the medical profession, this office will close as of July 1."
Douglas' wife, Irma, described how a doctor would tell his pregnant
patient, after a check-up, "I'm afraid this is the last time I'll be
able to see you."
The doctors' worries about being paid by the province, rather than
patients, may have been genuine. But those concerns were amplified by
Saskatchewan's opposition Liberal Party, which had been shut out of
power since 1944. Like the American Republicans 50 years later, the
Liberals fought health reform in two ways: directly, by opposing it in
public; and indirectly, by supporting groups that could provide the
appearance of broad-based public anger. In Saskatchewan, the public
opposition to health reform came in the form of a movement called Keep
Our Doctors, which organized rallies and protests across the province.
Sometimes, the Liberals blurred the line between political opposition
and rabble-rousing. At a Keep Our Doctors rally outside the provincial
legislature, Liberal leader Ross Thatcher used the occasion to call
for a special session of the legislature, which wasn't sitting at the
time. To illustrate his point, he invited TV cameras to follow him up
to the locked doors of the legislature, which he then made a show of
trying to kick down.
But in another precursor to today's Tea Party movement in the United
States, the unrest over health reform in Saskatchewan proved to be
more than just political theatrics. "The fears inspired by the doctors
and fanned by the Liberal party," Shackleton writes, "convinced many
people at least briefly that the CCF was a dictatorial, power-mad,
ruthless group of politicians who would rather see people die for lack
of medical care than back down." Shackleton described "a sense of
civil war." (Read more about the unrest in Saskatchewan.)
Public anger against the plan found its lightning rod in Douglas, who
had resigned as Saskatchewan's premier to run for federal office as
the member of Parliament for Regina. Election Day was June 18,
1962just two weeks before the new health care plan was to take
effect. A woman who worked on Douglas' election campaign recalled the
venom of the time. At night at the campaign office, "teenagers would
come up and hiss at us through the glass," she remembered later.
"The city's residents had been whipped into a near-hysteria by the
doctors' anti-medicare campaign," Margoshes writes, adding, "There
were graffiti threats on city walls and calls in the middle of the
night to Tommy's house. His campaign manager, Ed Whelan, got frequent
calls from a man threatening to 'shoot you, you Red bastard!' A few
homeowners placed symbolic coffins on their front lawns."
As in the United States today, opponents of the health reform plan
weren't sure whether to denounce the CCF as Communists or Nazis, so
they did both. Protesters greeted Douglas' motorcade with Nazi
saluteswhen they weren't throwing stones at it. Other opponents
painted the hammer and sickle on the homes of people thought to be
associated with the party.
The doctors made good on their threats: When the new health care plan
was introduced on July 1, doctors across the province walked off the
job. But the government was ready, flying in replacement doctors,
mostly from Britain. The strike ended after three weeks, the health
care plan stayed in place, and four years later, the Canadian
government passed the Medical Care Act, which provided funding for
every province to create a similar plan.
Douglas and his party were vindicated. Once their plan took effect,
Shackleton writes, it "was soon so well accepted that no political
party had the temerity to suggest its abolition."
But that vindication came too late. Douglas, who had led the CCF to
five straight provincial victories, lost his federal campaign that
June, receiving barely half as many votes as his opponent. Two years
later, the Liberals defeated the CCF for the first time in 20 years.
The party that passed health care reform would spend the next seven
years out of power.
The events leading up to the 1962 doctors' strike in Saskatchewan are
different from today's Tea Party movement in important ways, of
course. Saskatchewan wasn't seized by the same level of broad distrust
for government that U.S. opinion polls show today. The idea of a
government role in health care was already accepted, to a degree:
Saskatchewan had already passed the Hospital Insurance Act in 1947,
which paid for hospital care. And the changes Democrats have called
for stop well short of single-payer health care, notwithstanding the
charges of their critics. Even the AMA supported Obama's plan.
But the anger of those months in Saskatchewan undermines a key belief
in the debate over health care reform. When confronted with the
overall success of Canada's brand of government-funded health
carebetter health outcomes at much lower costAmericans tend to
respond that such a broad government role is anathema to American
culture. This has the ring of an excuseafter all, the idea was
apparently somewhat anathema to Canadian culture in 1962. As Douglas
said then, "We've become convinced that these things, which were once
thought to be radical, aren't radical at all; they're just plain
common sense applied to the economic and social problems of our
times."
The point isn't that U.S. and Canadian cultures aren't different.
Rather, it's that cultural attitudes aren't static. However much some
segments of U.S. culture may resist Obama's proposals, the
Saskatchewan experience suggests that resistance will dissipate if the
plan produces a system that works better than the status
quoespecially since, as in Saskatchewan, the government was elected
on a promise to make that change.
The other lesson of Saskatchewan is less exciting for Democrats: Even
if people come around to the reform itself, they may not come around
to the party that pushed it through. If they want to achieve health
care reform, that may be a chance that Democrats have to take. But
re-election qualms shouldn't be dressed up with bromides about the
limits of what's possible. As Canadians can attest, health care reform
takes a little more backbone than that.
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Doris French Shackleton, a biographer of Tommy Douglas, describes the
mood at the time:
The anger crackled in the air. Every business interest, every
insurance agent, every local Chamber of Commerce
now aided and
abetted the doctors' cause with every resource at their disposal.
Stores were closed to swell "Keep Our Doctors" rallies and parades and
marches on the legislature. Newspapers and radios bristled with
accusations. There was, as many testified, a sense of civil war.
Shackleton tells of the story of an elderly priest, Father Athol
Murray, inciting a "Keep Our Doctors" rally in Wilcox, a small town 25
miles south of the provincial capital, Regina. "This thing may break
out into violence and bloodshed any day now," Father Murray told the
crowd"and God help us if it doesn't."
A volunteer on Tommy Douglas' federal election campaign, which came at
the height of the unrest in Saskatchewan, tells this story: "I drove
home one day with a taxi-driver. He was a man who could really have
benefited from Medicare. He had no teeth: he had had them all
extracted. He said he had five children and a sick wife. And he
blasted me about Medicare and about Tommy. There was no arguing with
him."
Christopher Flavelle reports for ProPublica, the nonprofit
investigative newsroom in New York City. He is Canadian.
Article URL: http://www.slate.com/id/2245037/
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Larry C. Lyons
web: http://www.lyonsmorris.com/lyons
LinkedIn: http://www.linkedin.com/in/larryclyons
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