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History: 1958-1968 PUBLIC OR PRIVATE? VOLUNTARY OR COMPULSORY? : HOSPITAL CARE FOR CANADIANS, 19481958 CONFLICT AND COMPROMISE: CREATING THE MEDICAL CARE AC, 1958–1968 FROM COST CONTROL TO HEALTH PROMOTION: IMPLEMENTING MEDICARE, 19681978



The Federal Proposal

Although federal and provincial health bureaucrats worked out a series of individual provincial agreements in the spring of 1965, the Federal–Provincial Relations Unit of the Department of Finance, led by former Saskatchewan Deputy Minister Al Johnson, expressed serious reservations about the Department of National Health and Welfare’s plans, because they harked back to the shared-cost approach of the Hospital Insurance and Diagnostic Services Act rather than looking forwards to the more open-ended approach of cooperative federalism. As a result, when Prime Minister Pearson met with the federal Minister of National Health and Welfare and the provincial premiers in July 1965 to discuss medical services insurance, the proposal that he presented represented the work of the Department of Finance and the Privy Council Office, not that of the Department of National Health and Welfare. In contrast to the Hospital Insurance and Diagnostic Services Act, this proposal outlined the four principles that had to be in operation before federal funding would commence. Provinces had to have publicly administered, universal programs providing access to medically necessary services for their citizens, and these benefits were to be portable when people moved. Although the assembled premiers were surprised by the lack of central regulation, Alberta’s Ernest Manning promptly condemned the measure as an infringement of provincial rights, while W.A.C. Bennett of British Columbia rather more shrewdly observed that it looked like an election plank. Bennett was right. The Liberals called an election in September 1965, but were dismayed to find that their medicare proposal did not sway Canadian voters sufficiently to win them a majority. This was because of significant advertising by opponents of medicare, as well as because of the scandals that tainted political life at the time.

Photo:  A. W. (Al) Johnson

A. W. (Al) Johnson, the pre-eminent public servant from Saskatchewan, at the Department of Finance, whose vision of co-operative federalism steered the medical insurance proposal into its final form.
University of Saskatchewan Archives, A-10404

Photo: “Now for my next act —” Rivard’s capture, Rivard’s escape, bribe attempt, Dorion Inquiry, Cabinet shuffle
“Now for my next act —” Rivard’s capture, Rivard’s escape, bribe attempt, Dorion Inquiry, Cabinet shuffle

In Duncan Macpherson’s cartoon of July 19, 1965, an inept, fumbling Lester B. Pearson is handed the medicare proposal, pulling a rabbit out of a hat to rescue his scandal-ridden government from public censure.
Library and Archives Canada, Acc. No. 1987-38-328, C-137462. © Estate of Duncan Macpherson.



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    Date Created: March 31, 2010 | Last Updated: April 21, 2010