Socialized Medicine Began In Alberta
Date: Wednesday, November 09 2005
The healthcare reform movement has not addressed the basic fundamental need to completely restructure health care delivery for the good of people and not for profits of the medical establishment and their bueracratic institutions. Medicine, and medical delivery has never been devised by the people who use it or even those who fund it. Medical delivery is part and parcel of the monopoly of the medical establishment, the good old boys who run the Provincial Medical Associaions and the College of Physicians and Surgeons in each province.
The Canadian Medical Association while created in Ontario was to become dominated by the Alberta Medical Association, due to the advanced development here after Alberta became a province.
The first hospitals in Alberta were private, operated by the Catholic Church. But we the people in Edmonton developed our first public hospital, with an elected board, which was to become the the Royal Alexandera Hospital.
Every civic election until the 1960's when an appointed board took over, saw the election Hospital Board Trustees as well as School Board Trustees, Mayor and City Aldermen. In fact during the 1930's when labour ran city hall aldermen sat on city council and as both school board and hospital trustees.
The first act of the new Alberta Government was to recognize the monopoly of Doctors as a profession and guild in charge of medicine in the province. It was a recognition of their education, training and professional status. And of course their political power, as many were active in the governments of the day and in the ruling political parties. In civil society they were involved in the police forces, the founding of the University of Alberta and in fraternal orders such as the Freemasons, who were highly influential in Alberta's development as a province. They were in fact 'hegemonic' ,as Gramsci called it, within the newly constituted State in Alberta . They had a view of civil society that was based on social need, as a meritocratic order they used their status in society to promote social medicine for the province and the country.
Under the Liberal provincial government 1905-1908, the earliest acts they passed were those recognizing the University of Alberta, the Grand Lodge of Freemasonry, and the formation of the Alberta Medical Association, and the creation of the College of Teachers. Thus the state and civil society became one in Alberta one hundred years ago.
Once Alberta became a province it set the agenda for public health care, for promoting Medicare in Canada as well as establishing medical training programs, and helping to maintain the Canadian Medical Association. First under the Liberal provincial government in 1912, and then under the populist farmer worker alliance of the UFA (United Farmers of Alberta) government till 1935, public medicine in Alberta was seen as a necessity for this largely rural province.
Socialized Medicine originated in Alberta. Even under the later right wing government of Social Credit under both Premiers Bill Aberhart and Ernest Manning (Prestons daddy) socialized medicine was seen as a necessity and promoted by the government. Albertans demanded it and we got it.
And what was good for Alberta eventually became good for the whole country when Tommy Douglas, Leader of the left wing CCF, Premier of Saskatchewan, and Freemason introduced a single payer public medicare system in his province.
But Douglas developed this system into Saskatchewan after Alberta had set up our own MSI program in 1944.
Alberta and Saskatchewan waited for the Federal Government to introduce a national program after WWII as promised by the then Liberal government, but none occurred.
Alberta maintained its private public insurance program while Tommy Douglas developed the first single payer social model in North America. The model was originally developed in the United States and lobbied for there by the labour movement.
The Alberta program was an early form of public private partnership, since it still did not cover 100% of all Albertans and was supplied by a private insurer associated with the AMA. It was setup with government funding, it still charged Albertans as a modified user pay system. Nonetheless it was the first public Medicare program in Canada until Douglas introduced modern 100% government based socialized Medicare to Saskatchewan in 1961.
The dispute between the Alberta Model of MSI with its user pay system and Douglasís single payer 100% government funded model continued through the sixties. And it is still with us today as Alberta is one of the few provinces that charges health care premiums.
Once again proving that user pay philosophy of the right wing remains intact here. Whether Socreds or Conservatives, they grudgingly accepted a national Medicare program, but they still insisted on the Alberta way of doing it, they never gave up their MSI ideology.
Alberta under the Social Credit party of Ernest Manning, fought to maintain the two tier private insurance program against Tommy Douglas's single payer form of medicare, even after the Federal Government accepted it as the national program. During the reign of the Progressive Conservatives of Peter Lougheed an unprecidented expansion of the public service as well as a construction boom in hospital and long term care facilities occurred. It reflected the wealth of the oil boom of the seventies in the province and the political accumen of the Lougheed gang in getting rural and seniors votes.
With the oil crisis in 1984 and the crash in the market the Getty Government faced a crisis in building and staffing infrastructure. Further attempts at diversification by the government led to many startling business failures. The government became scandal ridden. In came Ralph Klein and the Calgary/Southern Alberta right wing, with their neo-liberal agenda and Alberta became a laboratory for privatization and market models of public service delivery.
The Klein government closed and blew up hospitals, transformed rural hospitals into long term care facilities, privatized laundry services in Edmonton and Calgary Hospitals (giving the contract to Tory insiders), reduced funding for univeristies resulting in a decline in training of nurses and doctors, laid off hospital staff, and of course froze wages and benefits forcing those not laid off to look for work elsewhere. They also consolidated the hospitals into districts, removed control from boards and appointed their own lackies to the new District Boards.
What the Lougheed government had built the Klein government renovated, causing long serious and long term damage. Currently the lack of doctors and nurses in this province and across the country is a result of the decisions of 1995. In that year the Federal Government under Fianace Minister Paul Martin also adopted the neo-liberal model and reduced transfer payments to the provinces to reduce its debt. The federal government also embraced the Reinventing government model prevalent in the U.S. which promoted the contracting out of government services and the development of Private Public Partnerships (P3's).
The result of this move to the right provincially and Federally left public health care seriously undermined, as the right hoped in order to 'level the playing field' in order to introduce a market driven model of for profit health delivery in Alberta. The old hospitals in Calgary that weren't blown up were sold at fire sale prices to private medical companies, which again had ties to the Tory government.
Health boards were stocked with former Tory ministers. And new delivery models of health care became the reform agenda of the government, including its disatorous attempt to intorduce fullscale privatization with Bill 11. Mass protests stalled the bill but the Federal Government was in no position to oppose it since it had abdicated its fiscal responsibilty for health care with its cuts.
For the last decade the Klein government has driven the agenda of Health Care Reform in Canada, and its model is that of private public insurance (MSI) combined with public funding for private service delivery.
In the past two years the Klein government and its supporters on the right ( The Fraser Institute and Preston Manning and Mike Harris) has realized its reliance on the American model is a political deadend in Canada. So now they are looking to Europe for P3 models to emulate.
But the fact remains it was their very attack on the public funding and delivery of medical services that created the problem in the first place. While claiming to have to spend billions in providing public health care, the reason is that they are rebuilding a social infrastructure that they blew up during the Klein Revolution and the Martin Budget of 1995.
The money is not the problem, as America's increasing costs for medicine prove, it is the failure of the government to develop a wide based public healthcare system that includes coverage for pharmaceuticals, dentistry, alternative delivery, etc. that is resulting in increased costs. Like the reform of public education and other so called reforms of the right these are not driven by cost considerations but by the ideology of privatization at all costs.
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