How Harrison is Helping Create a More Sustainable Public Healthcare System

By Don Copeman

In a famous speech delivered in 1979, the accepted founder of Canadian Medicare, Tommy Douglas, was quite specific about what it would take to make our public healthcare system financially sustainable. At the S.O.S. medical conference in Ottawa, an event that spawned important organized support for Medicare, Mr. Douglas spoke these important words:

“I am concerned, as many people are, about Medicare – not with its fundamental principles, but with the problems we knew would arise. And those of us that talked about Medicare back in the 1940’s and 50’s and 60’s kept reminding the public that there were two phases for Medicare. The first was to remove the financial barrier between those that provide health services and those who need them. And we pointed out repeatedly that that phase was the easiest of the problems we would confront. In governmental terms, of course, it means finding revenue, it means setting up organizations, it means exercising controls over costs – but in the long term it was the easiest problem.”

“The phase number two would be the much more difficult one; that was to alter our delivery system so as to reduce costs so as to place the emphasis on preventive medicine. And I think what we have to apply ourselves to now, is that we have not yet grappled seriously with the second phase. We must now move increasingly toward group practice whether its community clinics, cooperative clinics, clinics setup by the doctors themselves – but the need for group practice was to make possible the practice of preventive medicine – only in that way are we going to be able to keep the costs from becoming so excessive that the public will decide that Medicare is not in the interest of the people of this country …”

“And I hope from time to time we will gather, as we are gathering now, to the end that we may be able to build in Canada a program which will provide the maximum amount of good health and enable people to enjoy good health, provide them with remedial services when that good health is no longer present, and to do that without any fear of the financial burdens which have crippled so many people in other places and in other times.”

Watch his full speech here. 

That was 1979, and it seems in hindsight that very few people took notice. I graduated from university in 1978. As it should have been, being a young man in my twenties, I had the heart of a socialist. It is now 2022. I still have the heart of a socialist, but I have developed sensibilities that I believe the founding father of Canadian Medicare would have whole-heartedly supported given our current circumstances.

Tommy Douglas was right. We do indeed need to focus on prevention. And if this gifted man was alive today, he would realize that the escalating costs of “remedial services”, born in a new era of unprecedented research and technological advancement, would limit the ability of the “public purse” to provide effective preventive care. When you add the growing complexities of our society since 1979, and new-found stressors that have created more unhealthy behaviors and complex chronic diseases, you arrive at a very worrisome place if you are a public healthcare official – or a simple supporter of sustainable public healthcare, as I am.

By 2004 I had almost 20 years of healthcare experience behind me. With almost each passing day, being ever more exposed to the realities of the situation, I realized that something needed to be done that could counter-balance these new pressures. I believed more than ever that prevention was the key.

In 2005 I created a healthcare company that was dedicated to prevention. In 1979 the important role held by professionals other than doctors, was not as obvious as it was in 2005. Psychologists, counselors, social workers, dietitians, exercise physiologists, nurses, care navigators, and others had become essential for therapeutic lifestyle change and therefore, truly effective disease prevention.

I thought it was time for choice. People could rely solely on doctors for prevention, or those doctor’s services could be intertwined with these other important professional services to significantly reduce the costliest aspects of healthcare, namely specialist appointments, complex chronic disease management, emergency room visits and hospital stays.

This idea works. There is now an irrefutable body of scientific and medical evidence.

In Canada, many people believe that such services are only available to the wealthy. That has not been my experience. Over the last 17 years we have compassionately cared for people from all walks of life. It has simply been a matter of how people choose to spend their disposable income. I think that Tommy Douglas would think that’s OK, if it inches us forward to public healthcare sustainability. At no point did he ever say that there was no room for private options. In fact, he said quite the opposite in his 1979 speech, since even after Medicare was established, most physicians operated private practices. The funding source simply changed. This remains a fact to this day.