Waiting lists, access to specialists and high-tech diagnostic equipment, privatization and two-tier care are among the many issues Canadians have expressed concern about to pollsters, as governments have tried to determine how to reform Canada’s health care system between 1989 and the present. Poll after poll, however, has indicated that citizens have continued to support medicare’s underlying values. Indeed, many letters to the editor have demonstrated its iconic status. As Sylvia Shortcliffe wrote in August 1996:
The “noisy clash of ideas and principles” was to continue as federal and provincial governments attempted to deal with economic challenges such as the 1989–1992 recession and the ballooning deficits that prompted stringent measures to cut social spending. In the 1990s, these measures resulted in downsizing that affected nurses and other hospital staff, prompted doctors to move to the United States, and led to numerous provincial commissions that proposed restructuring the health care system. The media contributed to the growing public concern by highlighting tragic stories of individuals whose needs were not met, and emphasizing the conflict that was erupting between Ottawa and the provinces, especially Alberta, Ontario and British Columbia. By the beginning of the twenty-first century, anxiety among Canadians about the future of the health care system was intensifying as the pro- and anti-medicare forces battled. Health issues consistently topped the polls as a primary political concern for Canadians. For patients, health care providers, academics, policy-makers, bureaucrats and politicians alike, fixing medicare had become the endless challenge.