The 1962 battle over Canadian health care: Labor pains

Whole Earth Review, Winter, 1995 by Steven A. Lyons

I was less than sixty seconds into my interview with Dr. Barootes and things were not going well. People familiar with my subject's disposition had warned me to expect a less-than-warm reception. They were optimistic.

The doctor was immediately suspicious of an American interested in the health policy opinions of a seventy-six-year-old urologist from Saskatchewan. Things turned from bad to worse:

"And what is your position on health care reform?" he inquired.

"Well, I'm trying to write an objective article."

"That ... is ... not ... what ... I ... asked," he growled.

The last us congress killed government-led health care reformoutoffear that it would interfere with the patient-doctor relationship, increase bureaucratic limit patients' choice of doctors, and ultimately lead to rationing of health care.

We are spiraling toward the Orwellian form of health care envisioned by Congress. But Big Brother is not the government. Rather, as huge managed-care corporations control larger and larger portions of the health delivery system, profit, not quality patient care, is driving the health care industry. Every fear that the 103rd Congress had of a big government health insurance program is coming true, thanks to big private health insurance companies.

Lawmakers were concerned that the Clinton health care plan would limit our choice of doctors. However, all managed-care programs limit the patient's choice of doctor to providers that are employed by or approved by the insurance company.

People attacked the Clinton health plan as increasing government bureaucratic waste. However, in a recent study, the California Medical Association found that California's private health insurers squander eight times more in administrative overhead than the state-run health insurance program. Nationwide, about one of every four dollars is wasted on overhead by the private insurance industry.

The 103rd Congress feared that the Clinton health plan would intrude upon the doctor-patient relationship. But under private health insurance plans, three out of four doctors sign contracts surrendering their medical decisions to insurance company oversight. One large company's managed-care plan prohibits patients from calling their doctors directly. Instead, the employee must call an insurance company representative, who in turn calls the doctor.

People feared that government health insurance would lead to rationing of health care. Now, under private health insurance, hospitals are discharging patients quicker and sicker to save money. With managed-care plans discharging mothers and their newborns as soon as eight hours after birth, legislators have had to intervene to force the insurers to cover at least forty-eight hours of postnatal care.

In 1993, when Representative Jim McDermott and Senator Paul Wellstone proposed a Canadian-style single-payer health care program for the United States, it was considered politically impossible. The proposal never made it to the House floor, even though the Congressional Budget Office estimated the system would save $175 billion annually by the year 2003, completely eclipsing the savings of any other health reform proposal.

Since managed care is rationing health care, interfering in the relationship between doctors and patients, and burying everyone in paperwork, we might ask an innocent question: "Tell us again why we should avoid a single-payer system?"

Canadians have lived with their version of health care reform since 1962, when the Canadian government began providing cradle-to-grave health coverage for all its citizens. On the surface it seems it can't be any worse than the direction our system is headed.

But opponents to the single-payer system contend that Canada rations health care and provides a lower standard of care, all due to its tax-financed health system. I decided to search for the tender underbelly of the Canadian system, to determine who was right.

My search for the dark side of the Canadian Medicare system (as it is called) quickly led me to one man. If the Canadian system has any shortcomings, Dr. Efstathios W. "Staff" Barootes would be more than happy to expose them. Back in the early 1960s, Barootes vigorously crusaded against the implementation of government-sponsored health insurance in Canada. Canada's single-payer health care system began in Saskatchewan. Barootes was vice president, and later president, of the Saskatchewan College of Physicians and Surgeons, a group determined to prevent any program that involved tax-financed health care for the entire population. He was president of GMS, the doctor-sponsored private medical insurance plan in Saskatchewan. In a 1960 televised health care debate with the premier of Saskatchewan, Barootes argued against the proposed health insurance scheme. In 1962, in an emotionally charged speech to a mass meeting of doctors, he received the loudest applause when he proclaimed that "Never ... has there been such legislation reversing the civil rights and liberties of citizens." And Barootes served as Sadkatchewan's conservative party senator in Ottawa from 1984 until retiring last year. Now, if anyone in Canada could expose the tender underbelly of the Canadian health care system, Dr. Staff Barootes could.