Making Medicare:  The History of Health Care in Canada, 1914-2007 Back to Timeline Back to Timeline
History: 19781988 FROM COST CONTROL TO HEALTH PROMOTION: IMPLEMENTING MEDICARE, 19681978 SAVING THE SYSTEM: THE CANADA HEALTH ACT, THE OTTAWA CHARTER AND ACHIEVING HEALTH FOR ALL, 19781988 THE ENDLESS CHALLENGE: BALANCING CHANGE AND CONTINUITY, 19892007



The Conservative Agenda: Achieving Health for All

Brian Mulroney and the Progressive Conservatives defeated the Liberals, led by John Turner, in September 1984. Jake Epp,a Mennonite from Manitoba, became the Minister of National Health and Welfare charged with implementing both the Canada Health Act and the Conservative Party’s promise to limit government spending on social programs. By slowly developing the Canada Health Act’s sole regulation and cautiously applying its penalties, Epp was able to calm most provincial opposition to the legislation.  As well, he worked with his staff to shift federal attention from curative to preventive activities. The Health Promotion Directorate had been created in 1978, and its initial campaigns supporting physical fitness and good nutrition and opposing smoking and alcohol and drug use had not only strengthened provincial and municipal programs, but had also attracted international attention. Through funding the Beyond Health Care: From Public Health Policy to Healthy Public Policy conference in Toronto in 1985, the Department of National Health and Welfare indicated its support for a new paradigm: health promotion. Experts from the European Office of the World Health Organization attended the Toronto meeting and then persuaded the organization to choose Ottawa as the site of the first International Conference on Health Promotion in 1986. To make the most of this opportunity, Epp’s staff worked tirelessly to prepare a document that reflected the new thinking on this topic. Achieving Health for All: A Framework for Health Promotion built on the Lalonde Report by reminding citizens that, in spite of medicare, Canadians still faced three fundamental challenges: “reducing inequities in health, increasing prevention and enhancing people’s capacity to cope with chronic disease and disability.” The framework also outlined

three health promotion mechanisms to address these challenges: self-care, mutual aid, and healthy environments; and three implementation strategies to operationalize the mechanisms: fostering public participation, strengthening community health services, and co-ordinating healthy public policy. (Lavada Pinder, “The Federal Role in Health Promotion: Art of the Possible,” in Ann Pederson, Michel O’Neill and Irving Rootman, eds., Health Promotion in Canada: Provincial, National & International Perspectives [Toronto: W. B. Saunders Canada, 1994], p. 100)

By “healthy public policy,” Achieving Health for All meant “income security, employment, education, housing, business, agriculture, transportation, justice and technology.” Jurisdiction for each of these areas belonged to other federal and provincial departments and hence work on the issues would require intersectoral cooperation. But the framework was merely a discussion document that was prepared, like its predecessor, with limited external input. As a result, it did not have the impact that was necessary to shift Canadian health care policy away from its focus on curative interventions.



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