SNOBELEN: Canada’s health-care system requires innovation

Inevitably, public health care turns the noble practice of medicine into a bureaucratic function. Neither the doctor nor the patient is well served.

Published Oct 16, 2026  •  Last updated 22 minutes ago  •  3 minute read

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If you like irony, you must love Canadian health care. Consider the recent demand that the federal government intervene to squash the dual-practice medical model in Alberta. You might wonder whether the four former deans of medicine from Alberta who launched the appeal to Ottawa had a strong sense of humour or simply lacked any knowledge of Medicare’s origins in Canada.

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The old prairie preacher and politician Tommy Douglas is often called the father of universal health insurance in Canada. Back in the 1950s, Douglas served as the premier of Saskatchewan and championed some significant changes, not the least of which was universal health insurance to protect people from financial peril resulting from a major illness or injury.

It seems the North American health-care establishment was not enamoured with Douglas’ ideas. Doctors feared that government would take over the practice of medicine, drive down wages and swamp the province with “foreign” doctors.  They weren’t entirely wrong.

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In 1962, Saskatchewan adopted the health-care insurance plan and doctors went on strike. That strike lasted 28 days. The public did not warm to the doctors’ position. It’s hard to sympathize with striking doctors when your kid is sick.

On the other hand, people expect governments to keep basic services working and things don’t get more basic than a doctor’s office. In the end, the government amended the legislation to allow doctors to opt out of Medicare, gave a bump in pay for services and the darn strike ended.

Government would dictate medicine practice

Some form of public health insurance makes sense to most folks and wise politicians listen carefully to the people. Another prairie politician, Prime Minister John Diefenbaker, encouraged provinces to adopt the Saskatchewan model and offered that the federal government would pick up half the cost. And so began the spiral of free health care.

Which gets us back to those four deans that seem upset with the idea of a mix of public and privately funded health care. It seems to me it might be a good time for a look back at the concerns doctors had at the dawn of public health insurance.

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Back then, doctors had this weird idea that government would start dictating the practice of medicine. Turns out they were (kinda) right.

Provincial ministries of health are in the business of rationing care. They provide funding for diagnosis only if the patient meets a preset condition. They limit the time a doctor can spend in consultation with a patient. They restrict the procedures and medications that can be administered. No matter how rational the rationing is, the constraints obviously limit a doctor’s ability to meet an individual patient’s needs.

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Inevitably, public health care turns the noble practice of medicine into a bureaucratic function. Neither the doctor nor the patient is well served.

Perhaps because of the turmoil at its birth, the public health insurance system has always been evangelically attached to a mythical single-tier model. Single tier is an illusion. People with means or influence (like deans of medicine) have better access to care everywhere.

Meanwhile, aging infrastructure and spiralling costs are dooming the traditional hospital model, while AI revolutionizes diagnostics and treatment. In the face of change, the health-care cartel continues to relitigate tired, old battles.

So here is some free health-care advice for politicians: Ignore the health-care Eeyores. These times call for innovation, even if a few myths must die.

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