2nd Stage of Medicare begins as Ontario passes Bill 41

2nd Stage of Medicare begins as Ontario passes Bill 41
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About the Author

Gary J. Machan

Gary J. Machan

Gary Machan serves on the Community Advisory Research Committee for the Canadian Index of Wellbeing. Through the course of his career he has received several provincial awards including the 2nd Stage of Medicare, Ontario Tobacco Network Innovation Award for Excellence, and Food Champion Award. In addition, Mr. Machan is an associate with the Centre for Inner Freedom where his work was featured by Tom Harpur in his best selling book ‘Finding the Still Point’.

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For all that we pride ourselves on having access to universal health care, what many Canadians don’t know is that there was to be a 2nd stage of Medicare. Tommy Douglas was, in fact, miles ahead of the rest of the pack in terms of articulating a vision whereby once Canadians had access to health care there was to be a second stage in which the emphasis was to be on health promotion aimed at keeping Canadians healthy. Prevent more to treat less.

It is for this reason that I regard the passing of Bill 41, otherwise known as Patients First, as a significant milestone, not just provincially, but nationally. Precisely, because it provides a legislative framework which gives the Local Health Integrated Networks a clear mandate to support health promotion and prevention work right across the continuum of health care services, such as was not the case previous to this legislation.

In fact, had this legislation not been enacted, it is highly plausible that we would have continued our regression towards an illness system, and in so doing re-divert resources away from health promotion into acute care,  sealing the fate of medicare as a failed experiment. Mind you, not because the vision was flawed, but because it was never fully implemented.

This is not to suggest that there aren’t some major red flags, not the least of which is the potential threat to community governance. Let us not forget that had it not been for the formation of community governed primary health care organizations in response to the doctors strike i.e. Community Health Centres, Medicare would never have got off the ground. There will need to be strong steps taken by the Ontario Health Minister to ensure community governance remains a core element of primary health care.

This notwithstanding, Eric Hoskins can’t go it alone. It will be essential for all Ministries and levels of government to put their shoulder to the wheel, including the federal government. To cut health care spending by half at this time is nothing less than mind boggling, not to mention entirely unnecessary. And wouldn’t it be great if the federal government demonstrated some leadership and imagination with this portfolio. That part of Justin Trudeau’s legacy be the passing of a Canadian Wellbeing Measures Act.

As for the Ontario Medical Association’s vehement opposition to Bill 41, I am not sure about you, but I am definitely getting a strong sense of deju vu. Just as doctors mounted a fierce and vitriolic campaign against Medicare at its inception, sadly it appears history is repeating itself as evidenced by such placards as ‘Kill Bill 41’. Does this mean doctors don’t have valid concerns? Of course, not. However, I cannot help but wonder if they would have been better served by presenting some constructive solutions to ensure ALL people of Ontario have access to primary health care.

Regardless, if there is one lesson I have learned during my years as a health advocate it is the greater the change, the greater the resistance. Remember when municipal tobacco bylaws were first introduced? Restaurant and bar owners were screaming blue and predicting financial Armageddon. Meanwhile what happened? Their business actually increased because people didn’t have to worry about going out to eat and coming home smelling like an ashtray.

Bottom line, it says: show me a Health Minister that everyone likes and I will show you a Health Minister who isn’t doing anything. Like it or not, the status quo is no longer an option. Like it or not, transformational change is necessary and not just mere tinkering. So let’s work together in finishing what Tommy Douglas started: the 2nd Stage of Medicare.


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Readers Comments (1)

  1. Sue says:

    Thank you for such a considered, well-balanced report. “An ounce of prevention is worth a pound of cure” has been too long held underground and silenced.
    So I say, “Hear, hear!”

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