Woodrow Lloyd was premier when Saskatchewan introduced North America’s first public, tax-funded health insurance program in July 1962. Saskatchewan’s doctors resisted, saying it was state medicine and would interfere with their relationships with patients. The tension reached a fever pitch by May 1962, when the doctors held their annual meeting in Regina. Lloyd walked into a hostile room and delivered this speech.
“Medical care is not an optional commodity, it is a necessity”
The people of Saskatchewan for many years have clearly expressed their concern for the provision of adequate health services. They have done so because experience has indicated the inability of most of us to adequately provide such services for ourselves and our families. This has resulted in municipal doctor plans, designed to provide for rural medical service; in the construction of hospitals; in the control of tuberculosis; in widespread immunization for the prevention of communicable diseases that were once a scourge; in the cancer diagnostic and treatment program; in the mental health and psychiatric services; in the public assistance program for those on low income needing health care; and, of course, in the hospital insurance plan.
Doubtless many who are here today had misgivings when the Saskatchewan Hospital Services Plan was introduced in 1947. Probably there were institutions and communities as well who questioned the wisdom of the plan. Certainly some of the language used at that time, “regimentation,” “government taking over,” “unwarranted government action,” “unbearable economic burden,” is not unlike expressions currently used by some in respect to medical care insurance. Yet, today, the success of the Hospital Plan is beyond question and it is extremely popular. Every provincial government in Canada has followed suit and, moreover, as you know, the federal government has accepted a measure of financial responsibility.
Public wants it
I express confidence that in the same way the misgivings or fears which are now entertained by some regarding the medical care insurance program will be dissipated once you give the program a fair trial. Once this is done we are convinced that the satisfactory and productive partnership which has characterized the public program just mentioned can be expanded to the other fields of medical care.
Saskatchewan people have provided the funds to build and improve modern hospitals in which their physicians may work. They recognized the advisability of developing a full medical school in our province, and with it a first-rate teaching hospital. The desire of this same public of Saskatchewan for a method whereby the increasing costs of medical as well as hospital services may be lifted from the shoulders of individuals and families has been made abundantly clear in the public expression of the many organizations to which I referred earlier. The government has a responsibility to respond to this constructive attitude, and it would expect to be held to account if it did not meet its obligation.
No medical interference
May I now turn to the concern that seems to be evident, that the rights and privileges of doctors will be interfered with? As I gather from some statements made by the profession through their official spokesmen and from some comments made by individual physicians, there is a fear that the medical care insurance program will somehow severely restrict and limit the activities of the physicians.
May I assure you again that the government has no intention or desire to influence the exercise of your professional judgment. In prescribing medical treatment, your knowledge and your word are supreme. The government has no wish or intention to change or to challenge that supremacy. We agree that nothing should interfere with your right to use your best judgment as to the treatment to be prescribed. We agree that you must have freedom to choose the patients you serve and the location of your practice. On the other hand, the patient must have the right to his choice of doctor. We have tried to include in the act the necessary provisions to make this abundantly clear.
I am aware of, and greatly respect, your concern for a proper doctor-patient relationship. If this relationship is adequately protected under existing voluntary plans, I am unable to see how its essential components can in any way be interfered with by the Medical Care Insurance Act. Patients will be free to select the doctor in whom they place their trust and doctors in turn will be free to accept this trust . . .
Taxpayers have rights
There is another side to the picture of services to the public. There has been a great deal of discussion recently over concepts of rights—the rights of individuals, the rights of groups, the rights of professions. I want to deal for a moment with what I consider to be the rights and proper expectations of the people of Saskatchewan. I repeat that, as patients, we are perfectly willing to place matters involving medical judgments entirely in the hands of a highly skilled group such as you are. In enacting the Medical Care Insurance Act, however, we have said that we, as consumers of medical services, and as taxpayers, have a right to a say in how we pay our medical bills. We have a right to construct an administrative agency, responsible to us, to arrange for such payment. The act deals, therefore, not with medicine, but with economics and the administration of public finance. The act provides medical consumers with a voice in those economics and that administration.
Not a commodity
Medical services are essential to health and to life itself. Good medical services are part of the basis for a healthy, productive economy. Medical care is not an optional commodity, it is a necessity. When medical services are needed, they should not in the interests of each of us or all of us be denied to any of us. When a commodity or service is essential, our society has long since accepted that consumers have a legitimate right to a voice in making the essential governing decisions in such matters. That voice has been for medical care, embodied in the Saskatchewan Medical Care Insurance Act, an act passed by a properly elected legislature in the province of Saskatchewan.
Saskatchewan’s doctors staged a bitter twenty-three-day strike in July 1962 before accepting the new public health insurance plan. Within a decade similar health plans were in place in all Canadian provinces.
The Measure of the Man: Selected Speeches of Woodrow Stanley Lloyd, Bev. Koester, ed., 1976; pp: 107-114
Courtesy Biggar Museum & Gallery