Doctors On Strike? 1962 and the Birth of Canadian Medicare

In 1961, Saskatchewan CCF Premier Tommy Douglas moved to fulfill a campaign promise to provide universal medical care insurance— an effort that would produce fierce opposition from Saskatchewan’s doctors, culminating in a 23-day doctors’ strike in July of 1962. The program’s success resulted Canada-wide medicare coverage in 1968. What can be learned from this example, where progressive reforms were opposed by a well-resourced and entrenched establishment? Is this labour action by doctors — to defend their profits — an example of a bad strike? Why have efforts to expand medicare to include pharmacare and dental care stalled for so long?

Further reading:
Doctors’ Strike: Medical Care and Conflict in Saskatchewan (1967) by Robin F. Badgley and Samuel Wolfe
Bitter Medicine, Part One: The Birth of Medicare (NFB documentary)

A transcript follows the break.

Announcer: Negotiation has failed, and today, it’s come to a physical test of strength. The doctors have locked their office doors and say that, from now on, they will treat only emergencies.

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Kate: Hello, and welcome to The Alberta Advantage. I’m your host, Kate Jacobson, and joining me today are Roberta —

Roberta: Hello there!

Kate: Karen —

Karen: Hello.

Kate: And Joel.

Joel: Hello, hello.

Kate: Alberta’s healthcare system is in a bit of a strange place right now. There’s a global pandemic that’s going on, as you may know, and Jason Kenney’s government wants to build new, $200,000,000 private hospitals while picking a very public fight with Alberta doctors. Rural doctors in Alberta are increasingly unable to continue their practices due to Kenney’s policy changes, and a recent poll showed that 49% of doctors in Alberta are thinking about leaving the province because of Kenney’s government. This is pretty interesting to us here at Team Advantage because the last time doctors threatened to leave a province en masse was in 1962, and it was because Tommy Douglas was pushing to introduce a universal medicare program in Saskatchewan. And, upon further thought, Tommy Douglas and Canadian medicare often get credited as a kind of Canadian wonder, but a lot of people don’t really know much about the fight that happened to introduce medicare in the first place. So, today’s episode is going to examine Saskatchewan’s 23-day doctor strike in July of 1962. It’s a chapter in the story about how universal medicare eventually became implemented in Canada, but it’s also a story about how difficult it can be for a social democratic government to take on well-resourced and entrenched actors, even in the pursuit of something like medicare, which is an obvious common good.

Joel: So, before getting into what happened in 1962 and Tommy Douglas and all this, it’s worth maybe painting a bit of a picture of what medical care looked like in Saskatchewan, and in Canada more generally, before medicare was introduced. So, Saskatchewan has six hospitals in operation when it was proclaimed as a province in 1905, with 75 beds serving 250,000 people. A couple more hospitals were added in 1906. Nursing homes provided extra beds during overflow, and Roman Catholic sisters staffed new church-adjacent spaces. More hospitals sprang up in growing towns in the 1910s and 20s. In these decades, Saskatchewan didn’t provide as much dedicated healthcare space as Alberta and Manitoba, and the spaces were pretty rudimentary.

Kate: And generally, before medicare was brought in, private medical insurance and private doctors that charged fees were the most common form of care. In Saskatchewan, however, what’s actually quite interesting is that there were some alternative models that had arisen due to Saskatchewan being a province that is really large geographically, but it has a largely rural and a largely agrarian-based population at the time. So, Maurice Macdonald Seymour was a fundamental health administrator in Saskatchewan in the 1910s and 20s. He moved to Regina in 1905 and became the provincial commissioner of public health, which was then actually under the Department of Agriculture. And what Seymour did is: he ensured provincial financial aid was available for the six 1905 hospitals, and then he also organized the Saskatchewan Medical Association and, with the Canadian Public Health Association, founded the Saskatchewan Anti-Tuberculosis League, which established and supported sanatoriums — these were long-term recovery facilities, and they were pretty significant to treatments of several common illnesses until the mid-20th century.

Roberta: I just want to jump in for one second because there was a lot of band camps, and other sorts of camps, took place at an old TB sanatorium in Saskatchewan, and all these people would come back with these ghost stories about these creepy facilities that used to house people trying to recover from tuberculosis and then turned into summer camps and week-long camps. It’s very strange.

Karen: [laughs] Amazing.

Kate: So, this plan of Seymour’s, which was quite humbly named as the Seymour Plan, let residents of Saskatchewan receive free immunizations for diphtheria, which is a specific bacterial infection, as well as smallpox and typhoid, and he also promoted hygiene education.

Karen: So, Seymour retained Dr. Henry Schmidt in Holdfast in the regional municipality of Sarnia. Schmidt became the first municipal doctor in North America in 1915. So, a little bit of background on the municipal doctor plan — so, this is pretty important for, again, providing one of the foundations for what we know as medicare. The municipal doctor plan came into place in regions that feared having their doctor leave. The municipality would pay a doctor’s salary through taxation and general revenues, and everyone within the municipality’s footprint or area would see that doctor for treatment.

Joel: This municipal doctor scheme grew from 1914 into the 1930s and worked relatively well because the system encouraged early consultations and preventative medicine. But, by the 1940s, the system needed to be something more portable as people increasingly moved to cities that weren’t necessarily tied to a particular municipal doctor anymore.

Roberta: City and town-based doctors who didn’t like the municipal doctor plan because it deprived them of potential patients — the 1930s themselves were very rough on everyone, obviously (this is the time of the Great Depression), and doctors really were struggling at the time. Municipalities suffering from drought and crop failures were unable to pay doctors. It’s pretty difficult to employ one when you can’t even feed yourself and sell your product. So, broader regional plans inspired by Norway’s health plan were advocated for throughout the 1930s, and these would become models used for additional pilot projects. Now, despite the limitations of the municipal doctors’ plan, Saskatchewan health infrastructure from the 1910s to the 1940s allowed for significant research and improved outcomes for the population. Health administrator R. G. Ferguson directed the Anti-Tuberculosis League and pioneered world-leading studies and treatments for the disease in the 1920s. And we have to remember — Saskatchewan’s tiny at this time, about 250,000 people. So, around that time, tuberculosis was the most common killer of white adults age 20-45 and was a devastating epidemic, in particular among First Nations peoples. Saskatchewan was the first province to provide free TB treatment, which was very expensive and a long-term process until the 1950s. Ferguson was especially concerned about the First Nations impact and encouraged immunizations. Saskatchewan also started pasteurizing milk, another first among the region. So, statistics point to Ferguson’s success in lowering the death and infection rates of TB over time. Universal programs related to TB partly set the stage for widespread health treatments to come. And it’s really helpful to understand the evolution that’s happening in Saskatchewan, that, even as a large geographical area with small population, it was really innovating in healthcare long before medicare.

Karen: Yeah. Part of the reason is because they were able to basically get everyone into these long-term studies of TB, and that was part of the reason Ferguson and others were responsible for lowering the rates and providing immunization.


Kate: So, to set the stage for this conflict with the doctors, we need to look at what the government was and how it was formed. And it was the Cooperative Commonwealth Federation, or the CCF, and they were elected to government in Saskatchewan in 1944. And one of the important pilot projects they did when they were first elected was the formation of the Swift Current Health Region in 1946, which covered about 10,000 square miles in southwest Saskatchewan and had population of 50,000 people. And, within the Swift Current Health Region, all visits to doctors would be paid for by collecting taxes. And what’s interesting is that, while the population of the area remained static from about 1946 to 1960, the number of doctors in the area actually more than doubled. Now, for the first decade the CCF under Tommy Douglas was in power, they were mostly concerned with economic development, and it actually took the Liberal opposition reminding Douglas that he had committed to implementing public services in 1954 to get some movement on that.

Roberta: So, in 1957, the Douglas CCF government introduces what becomes known as the Hospitalization Plan. And the basic idea of it was that the government, through taxation, would pay for any hospital visits that people had. And this was, really, the first step towards a state-insured healthcare system. And then, in 1958, the federal government realized that, “Oh, wait, this is actually a really good program — people really like this, it’s very popular and relatively inexpensive to actually fund healthcare as a unified force.” And so, in 1958, after the federal government had studied the issue, hospital costs began to be shared by the federal government. This sharing of hospital costs created capacity in the province to expand its commitments — so, it freed up money to be able to pay for other programs. So, in 1959, in a campaign stop for the lead-up to a provincial election that would occur in 1960, Tommy Douglas announced his government’s intention to implement a comprehensive medical care insurance plan that would cover the entire population.

Kate: And, in this plan, Tommy Douglas outlines five basic principles. One, prepayment — so, this means users never see a bill for the service. Two, universal coverage — so, it covers everyone, period. Three, a high quality of service — so, this looks like better distributing medical personnel between urban and rural areas, group practice, post-graduate work, refresher courses, fostering medical research, things like that. Four was that it must be a government-sponsored program administered by a public body, responsible to the legislature and — theoretically — through it, to the entire population. Five, it must be in a form acceptable both to those providing the service and those receiving it — i.e., doctors and the public, respectively; although, as you’ll see throughout this episode, this last principle would not necessarily be achieved.

Karen: The doctor’s profession had changed over the previous decades. While the pre-war period saw very few immigrant doctors in Canada, in the 1960s, a significant number of doctors in Saskatchewan were graduates of Great Britain’s medical schools. Many of them were opposed to the British National Health Service that had been launched in 1948. Most who had endured the drought and depression of the 1930s were no longer around or were retired — so, that would be the existing doctors who were not coming from elsewhere. The CCF, leading up to that point, had never separated the functions of the profession in licensing, setting standards, self-discipline, and trade union or negotiating. All these powers rested in the same body.

Joel: And that’s a bit of a strategic mistake. In retrospect, looking back on it, it’s like, okay — if they had maybe separated out these various functions within the professional medical discipline, they may have had a little more leverage to work with.

Roberta: So, the CCF called an election to be held June 8th, 1960, and the main plank in its platform was this medical care plan. And they said, in the platform, “Such a plan will mean coverage for all, comprehensive medical services, premiums within the reach of every family subsidized by general revenues, a major emphasis on prevention, encouraging early diagnosis and treatment, promoting medical research and education, encouraging the best distribution of doctors, coordination with other health programs, an emphasis on the value of human life.” In big capital letters — “HUMANITY FIRST! SUPPORT THE PARTY THAT MAKES PROMISES AND KEEPS THEM.”

Joel: So, the Saskatchewan College of Physicians and Surgeons, in its opposition to medicare, would align with the Chamber of Commerce and the principal political opposition, which was the Saskatchewan Liberal Party. The medical profession had studied the American Medical Association’s tactics opposing legislation in the United States and established a network within their roster of cells, or key men, who were reponsible for communicating with, and organizing, lists of doctors. They levied a $100 assessment on all doctors in the province to fundraise their opposition campaign. Of the province’s 900 doctors, 600 of them paid up — and, just to give you an idea, $60,000 in 1960 is the equivalent of half a million dollars in 2020. The Canadian Medical Association also donated $35,000, which is equivalent to about $300,000 in today’s dollars. They set up information centres in Regina and Saskatoon. The Regina office was headed up by a doctor who was a candidate during the election for the opposition party, and publicity kits were handed out to most doctors in Saskatchewan. One item included this little quote — “The concept of universal medical coverage is not new, and the approach by government to seek support is just the same as it was when first enunciated by Karl Marx in his Communistic Theories of the last century. Compulsion is an evil word — it carries with it the aroma of medieval times.”

Kate: Karl Marx famously said, “The more healthcare you have, the more communism it is.”

Joel: [laughs]

Roberta: I just love how “Communistic Theories” is capitalized, also. Like, this is an official thing — “Communistic Theories.” Love it.

Karen: Well, there’s a list of those too, so.

Roberta: It’s amazing.

Kate: So, Ross Thatcher — who was the leader of the Liberal Party in Saskatchewan at the time — opposed the CCF’s proposals for, quote, “socialized medicine.”

Roberta: I just have an aside about Ross Thatcher, too — sorry. I know all this ridiculous Saskatchewan history from growing up there and doing my Master’s degree on this period. So, Ross Thatcher was a weird dude. He was from Moose Jaw, or elected from Moose Jaw, and he was a businessman — but, originally, he was a member of the CCF and believed very strongly in government involvement in the economy. And then, by this point, he’s decided that he is not going to be a CCFer anymore and shifts to the other side, and he gets elected after this, which we’ll talk about later. But he gets elected and ends up a pre-neoliberal neoliberal capitalist in some ways. He tried to cut off funding to the universities for any sort of political activities — this might sound very familiar to people — he really cut back on taxes and services and really tried to be this opposition to Tommy Douglas. But he originally was a CCFer, and full-in. It’s such a bizarre story.

Kate: So, four days before the election, a full-page ad ran in the daily paper signed by 243 doctors from Saskatoon and adjoining areas. And what it claimed was that, quote — “Compulsory state medicine has led to mediocrity and a poor quality of care everywhere it has been put into practice. We believe that compulsory state medicine would be a tragic mistake for this province and would undermine the high quality of medical care which you now enjoy.” End quote. Despite this, however, the CCF won an increased majority, and they captured 38 of the 54 seats in the legislature. So that’s it — issue settled, podcast over, moving on.

Joel: After this election, the government very quickly puts together a medical care advisory planning committee which produces reports and recommendations, and it recommends the coverage of the entire population rather than a universal but voluntary opt-in program. One of its reasons was that the income levels of the great majority of people in the province were so modest that subsidizing those who were non-self-supporting at some time or another would be an extremely difficult and complex administrative task. So, basically, they were saying that means testing would be a huge bureaucratic nightmare, and also stupid.

Kate: Wow. Can you imagine this?

Roberta: It’s shocking that universal programs are actually cheaper. What a weird idea.

Joel: So, simply expanding voluntary insurance wouldn’t cover enough of the population, which would lead to uneven coverage in addition to requiring subsidies to prop it up. So, they recommended comprehensive medical service benefits, and they recommended premiums — we’ll find out later that the premiums bit gets ditched. The recommendations form the basis of the Saskatchewan Medical Care Insurance Act of 1961, which received royal assent in Saskatchewan on November 17th, 1961 — and, as I said, it did not include the premium stuff. And doctors were very upset because they didn’t feel like they had been consulted enough. Even though an election had just been fought, they had spent wads on money on [laughs] a campaign opposing the CCF and the medicare program. And, yeah, they felt like they weren’t consulted. Professional organizations were consistently opposed to tax-financed healthcare for the entire population.

Kate: In my opinion, they were consulted, and people said, “That shit sucks, try again.”

Karen: Yeah, it seems pretty clear, but…

Joel: If you consider an election a consultation, then they probably heard a bunch.

Karen: Oh, I think they should have a referendum to just make sure.

[laughter]

Roberta: I love how conservatives think that elections are mandates when they win, but not when they lose. So, you know — fun times. Maybe they did need a referendum.

Kate: Well, to be fair, social democrats think that elections are mandates when they lose, but not when they win, so…

Roberta: Fair, fair point. [laughs]

Kate: Can’t blame ‘em.

Karen: So, Tommy Douglas stepped down as premier in 1961 to become the leader of a new national party combining the CCF with labour unions to become the New Democratic Party. Replacing Douglas as the premier would be Woodrow Lloyd. Premier Lloyd was an extremely serious, unsmiling, mild-mannered and dignified person, and this would characterize the CCF in the upcoming fight.

Roberta: You’ve got to feel a little bit bad for Woodrow Lloyd in a way, because Tommy Douglas is this towering figure of social democratic policies and programs — he’s the guy throughout this period, which is why he becomes the leader of the NDP in 1961 when it forms — but he basically is like, “Hey, let’s have this universal healthcare program that we know doctors are annoyed about and really opposed to. And, by the way, I’m out of here — Woodrow, take on over. You can do this.” [laughs]

Karen: [laughs] That’s why he’s not smiling.

Roberta: Exactly, it’s like — “You pick up this difficult project that I decided to start just before I took off to do something else.”

Joel: Yeah, it’s like — “Here’s a longstanding project of mine. It’s been a promise of ours for 20 years, it’s a giant hot potato — I’m just going to put it right in your lap, and then I’m going to go for the federal party. Bye!”

[laughter]

Roberta: “See ya; hope you enjoy it!” And this is the funny part about this glorification of Tommy Douglas as the father of medicare, or whatever you want to call him. Tommy Douglas, obviously, is an important part of this story, but Woodrow Lloyd definitely doesn’t get the credit that he deserves, that he had to stick around and fight this out when Tommy Douglas just wandered away and did his own thing at the federal level. So, a commission was to be appointed to run the plan. The minister of public health, William Davies, called the president of the doctors’ association, Dr. Dalgliesh, to propose a meeting, and Dr. Dalgliesh refuses. So, the government’s reaching out, doctors are refusing. Davies sends a letter proposing a meeting on December. Dalgliesh doesn’t reply for three whole weeks — now, it’s obviously Christmas and the holidays, and he states the doctors are just refusing to talk to the government. On January 5th, 1962, Davies writes again to Dr. Dalgliesh, doesn’t receive a reply. So, let’s keep in mind — in November, medicare is passed, then the government’s trying to meet with doctors to sort this out and get this plan going, but the doctors refuse to talk. So, by April 1st, 1962, the plan is supposed to come into place, but doctors are stonewalling and refusing to participate on this commission for implementing the plan. The government and the doctors actually don’t sit down at the same table until the end of March.

Kate: So, the commission, getting no meetings from the medical profession, writes directly to all the doctors in the province. And this is actually taken really badly by many doctors, who write back things like, quote, “As a member of what amounts to a trade union, I must refer you to my negotiating body,” end quote, or, quote, “I would not go behind their backs any more than any union men would go outside their union to discuss business with persons outside the union,” end quote. May I just say that I wish that more trade unionists adopted this attitude [laughs] towards the government in negotiations and collective bargaining. Say what you like about the doctors, but they are displaying some remarkable solidarity with one another in this episode.

Roberta: But what if we could just, you know, encourage or express our concern? Isn’t that enough? I don’t understand.

Kate: Or urge them?

Roberta: “We strongly urge” — isn’t that a lot?

Kate: Love to strongly urge.

Roberta: [laughs]

Kate: So, failure to negotiate basically leads the commission to delay the implementation day of this medicare program, and they shift it from April 1st to June 1st 1962. And, when negotiations break down, the doctors’ professional organization completely refuses the government model.

Joel: A special emergency meeting of doctors is held on May 3rd and 4th. Two thirds of the province’s 900 doctors attend, and here are some lines from that meeting. “Never, since the days of Charles II, has there been such legislation reversing the civil rights of citizens.”

Roberta: Oh my god, I love the historical knowledge of these doctors. It’s amazing.

Joel: Nerds. The premier, Woodrow Lloyd, actually addressed the doctors’ meeting and said, “I must say that I find disconcerting some suggestions that governments do not have such a responsibility, and, moreover, are not to be trusted when they attempt to discharge it. Attacks on the integrity of government as an institution can undermine the foundations of the very liberties we prize so much and can prevent the extension of those liberties.” And Premier Lloyd also expresses concern that the doctors’ campaign was purposefully making patients angry and anxious as a way of getting the government to repeal the medicare act. So, once he does his speech — there’s a few hisses, jeers, and boos that are heard while he’s speaking, and following his address, and in the presence of the premier, Dr. Dalgliesh called upon the meeting for an expression of opinion for those against the medicare plan, and 545 of the 550 present stood to their feet and started applauding loudly.

Roberta: I just want to know who the five were that didn’t stand.

[laughter]

Roberta: Like, can I find those people and shake their hand?

Joel: Five cool doctors at this one meeting?

Roberta: Exactly. Five people stood up.

Joel: It’s also interesting to read about this just because I can’t imagine a politician that would put themselves in a place where they would potentially have an overwhelming majority of people oppose them immediately after the speech. [laughs] Like —

Kate: Well, just imagine Jason Kenney going to a large meeting run by any healthcare union in this province, period. He would not do that because he knows he would get a bad reception from them. He would never put himself in that situation.

Roberta: It’s really interesting. I mean, Woodrow Lloyd was super gutsy in all of this — he really, really put himself out there. But they really were committed to this principle of getting the doctors onside. Like, they really did just refuse to push it through despite the opposition. And they easily could’ve done that — I mean, they had this huge electoral majority, they had this mandate, they’d been talking about it for twenty years, and they finally get this thing in place — they could’ve just rammed it through, but they really did try and get the doctors onside at all these points. Like, I can’t imagine somebody doing that these days, walking into a den of enemies with 550 people there ready to skewer you. It’s amazing to think about how far they went to try and get those doctors onside.

Kate: So, the government’s medical care insurance commission, which was charged with implementing the medicare plan, began running advertisements for vacancies in rural practice in the main medical journals in Britain and also in leading daily British newspapers. So, commissioners flew to Britain for two purposes. One was to fill existing rural vacancies, and the other was to see if it would be possible to recruit physicians to go to Saskatchewan temporarily if the strike took place. And what ends up happening is this pro-doctor pressure group gets formed; it’s called Keep Our Doctors, and they drew support from the usual crowd — so, opposition politicians, conservative businessmen, clergymen, anybody who didn’t like the government — but also other professionals — medical professionals, pharmacists, dentists, people like that. They used a lot of concerned housewives as spokespeople, but if you dig into it at all, many committee members and leaders were extremely close to the right-wing Liberal Party that was led by Ross Thatcher. And what their general line of argumentation was is that CCF medicare is the same as totalitarianism and is a massive loss of freedom. So, by mid-May, all practising doctors were supplied with signs to put up in their offices that read, “To our patients — this office will be closed after July 1st, 1962. We do not intend to carry on practice under the Saskatchewan Medical Care Insurance Act.” Doctors also received a form letter which they were encouraged to send to their patients stating that the new medicare act prevented them, in good conscience, from continuing to practice medicine in the province.

Karen: In late May, the Keep Our Doctors planned to converge on the legislature in Saskatchewan claiming to have 46,000 signatures. Thatcher — again, the Liberal leader — gave a speech and told the rally that this is a free democracy, and we’re not living in Russia yet. So, you get a lot of red-baiting throughout this debate.

Joel: Not just red-baiting — you also got racism. At one Keep Our Doctors rally, a caricature was featured of a supposed Saskatchewan government-imported doctor with a large Semitic nose, a Chinese pigtail, Middle East-style clothing, bearing a sign reading, “Saskatchewan Government Medicare Import.”

Roberta: It’s actually kind of impressive how they could mix together all their racist stereotypes into one little image. It’s an impressive feat of design.

Joel: The overlapping racisms there are impressive. The Saskatchewan Board of Trade also warned tourists about the dangers of coming to Saskatchewan, citing a letter from a doctor that read, “As of July 1st, 1962, my services will not be available. As a native of this province and a veteran of World War II, I refuse subjugation to compulsory socialism.” And also in this whole mess was a federal election. Tommy Douglas, who had stepped down in November 1961, was now trying to jump from provincial to federal politics. Saskatchewan tended to vote CCF provincially and Progressive Conservative federally, and they did this again on June 18th, 1962 — Tommy Douglas, running in Regina, was defeated. His campaign, because it was in the middle of this medicare battle, encountered enormous hostility, vandalism, and threats, and some commentary I read said that the medicare crisis made the 1962 federal election possibly the most unpleasant in Douglas’ career.


Roberta: So, on July 1st 1962, about 250 of the province’s 725 practising doctors began their annual holidays. 240 worked in 34 hospitals designated as emergency centres by the medical profession, and maybe about 35 were actively cooperating with the medical care plan. Some others continued to work for ethical reasons — my guess of the ethical reasons would be the Hippocratic Oath that they took to actually treat patients whenever —

Joel: Do no harm, that whole thing.

Karen: Yeah, pretty important.


Roberta: Yeah, you know — when people are in need, you treat them. So, the point here — some doctors are working, but many have already gone on holidays or withdrawing their services in other ways. The Keep Our Doctors committees held public rallies and organized TV panels across the province. One Keep Our Doctors rally in Saskatoon on July 6th featured a dramatic speech by Father Athol Murray of Wilcox, carried live over the radio. And this is a quote from that speech: “There are three reds here. I can’t see them — I can smell them. You communists may think we’re naive and hollow-chested, but we gave a hundred thousand boys fighting for the freedom you’re fighting against. You reds — I want you to know we’re as proud as hell to be Canadians. Tell those bloody commies to go to hell when it comes to Canada. I loathe the welfare state, and I love the free-swinging freedom.” End quote.

Joel: Seems like a completely reasonable and rational person to be talking about the issue.

Roberta: Yeah, it seems like he has a really logical approach to discussing the issues and trying to understand what’s best for Canadians, you know? Yeah.

Joel: Good grasp of the facts there. [laughs]

Roberta: Yes, indeed. I mean, it’s interesting, all this red-baiting, because it’s really this argument being made at the time that, if we implement this program, people aren’t going to be able to choose their own doctors — it’s going to be implemented by the state, they’re going to tell you what doctors you can see, and you’re not going to be able to get the services that you require, it’s going to be the state saying what you can and can’t get for healthcare, and it’s really the state interfering in this relationship between doctors and patients. These are all the arguments being made at the time. And I think it’s really interesting because they’re the exact same arguments being made now about privatization, right? In the United States, Medicare For All, the same arguments are being made, that you won’t get to choose your doctor, that the state will cut off services or will choose for you what services you’ll get, that it’s going to ruin this relationship between doctor and patient — and yet, as we know, we see that HMOs and private healthcare companies are actually the ones that get in the way of that relationship. But it’s the same sort of red-baiting, communist garbage that we hear over and over and over again.

Karen: At least the World War II analogy has fell off because that happened too long ago.

Roberta: True, and also — come on, are you serious that you’re saying that we gave a hundred thousand boys to fight for this freedom —

Joel: Come on.

Roberta: — and we’re not going to acknowledge the role the Communists played in actually defeating the Nazis?

Joel: The Red Army?

Roberta: Ugh. Same old, same old.

Kate: So, the most important rally of the KOD (Keep Our Doctors) was planned for the afternoon of Wednesday, July 11th, on the ground of Regina’s legislature, which is the most normal place to have protests in Regina. And dentists announced their offices would be closed so that they, their staff, and their patients could march to Regina. Retail march-ins planned a blitz in support of the rally, and Ross Thatcher of the Liberals called a Liberal Party caucus for the day of the rally, demanded a special session of the legislature, and told the premier that the opposition would be in their seats in the legislature to await the special session. And, on the days before the rally, radio, TV, and newspapers were absolutely flooded with Keep Our Doctors releases. There was donations solicited, full-page newspaper ads asked the Queen’s representative — the Lieutenant Governor — to dissolve the legislature; a whole brouhaha. And the government was very apprehensive about all of this because they felt that, if 30,000 or 40,000 people showed up, the anti-medicare campaign would absolutely succeed.

Karen: On July 11th, hundreds of cars converged on the provincial capital to present a petition. At one point, two students with pro-medicare placards show up. Angry demonstrators moved in on them. A watching US TV station correspondent said, “This is just like covering the anti-integration movement in the southern United States. They’re the same kind of people.” A knot of demonstrators hemmed in the students, pushing them, telling them to drop dead or go back to Russia. The group also taunted the reporters who interviewed the youth.

Joel: Police had to intervene to protect a handful of government supporters who were cursed off the grounds with taunts of, “They are communists!” and “They are going back to Kremlin!”, and Ross Thatcher showed up and discovered the doors of the legislature locked, which ruined his whole “sitting in the legislature seats” shtick. He attempted to kick the door down for the benefit of the photographers nearby, saying, “We feel that these were tactics one would expect to find in Russia or Cuba. It’s just another indication that freedom is being extinguished in Saskatchewan. Premier Lloyd responded, however: “The opposition members had ample space to meet elsewhere. I see no point in making a farce of the legislative chamber.”


Kate: And, overall, the march was a failure. According to the press, only 4000 people attended. And, at the same time, doctors were quietly starting to go back to their practices, and senior officials with the Canadian Medical Association were really quite increasingly disenchanted with the behaviour of some of the strike leaders. At the same time, you’re also getting an increase in the income of doctors — there was 110 doctors that came to Saskatchewan to work during July of 1962. And, certainly, while the local press was in favour of the doctors and the strikes, the international press characterized it as both ethically dubious and distasteful. So, the Financial Post said a doctors’ strike is no answer, and it’s couched with this very, like, “The law is the way democracy works; they can’t be outside the law, it’s an assault on society.” And this is very interesting to me because, even in, essentially, defending Medicare, they are using a very reactionary position and a very emerging, reactionary position from the time — this would become increasingly common as we go towards the 70s — of: unions and any kind of disruption by unions is itself undemocratic and an attack on the fundamental fabric of our society. So that was really interesting for me to see because it’s kind of a precursor of what becomes a key discursive tool of neoliberalism in the 70s and 80s.

Roberta: Well, and I think — it’s interesting to me, at this point, what’s happening here, that — originally — the supports behind the doctors and the strikes happening and lots of doctors are on strike, but, early on in the strike — I think the first day of the strike — a young child dies because the family can’t find a doctor that’s willing to practice. There’s starting to be stories coming out about people struggling to find doctors, and — given their responsibility and the ethical role that they play in society — it becomes really difficult for them to justify this position. And then, I think the other part that we mentioned, but skimmed over, is this idea of 110 doctors coming to the province to work during that one month, that this raises a really tricky part of this history; that we, as I think good lefties, oppose people crossing picket lines and working during a strike, and normally we would call those people out as the scabs that they are. But this raises a really difficult ethical question, I think, because the Saskatchewan government basically just brought in a whole bunch of British doctors who had worked under the NHS and liked this idea of an ensured system and brought them in to cover the responsibilities of the doctors who went on strike. And I don’t know — do we consider them scabs? Do we not consider them scabs? How do we deal with all these doctors coming in? The reality is: doctors have a different role, and they’re trying to keep people alive, but it becomes a really difficult part of this story, I think.

Kate: I mean, to be honest, maybe I’m just being a bit flippant, but I actually don’t find it that difficult because every strike is legal, I believe, but not every strike is good. And I also think it’s important for us to remember that not every union is good. And that doesn’t mean some unions are better than others at fulfilling their duties, it means some unions represent people whose jobs shouldn’t exist in society. I’m thinking, here, a really obvious example is: we know the police are in their own unions, and I think we would all agree that those are not good unions because they protect workers that have a place in our society which is primarily causing harm. So, definitely, as a rule, absolutely — never cross a picket line. Fuck scabs, up the workers. But I absolutely think it’s pretty easy for me to look at a situation like this and say, “Oh, these are professional workers trying to break a universal medicare system that would absolutely a) fix a lot of problems in peoples’ lives, and b) advance class struggle in Canada.” So, to me, that is something to be opposed. And, sure, I think you can take this a little bit too far and start saying things like, “Oh, the building trades are bad because they work in the oil sands,” but I think if you just keep your head on straight and analyze things as you see them, it’s pretty easy — for me, at least — to draw a line between what I consider to be acceptable in terms of a labour dispute and what I don’t. I also think, in the case of doctors, you can almost see this as quite similar to a capital strike moreso than a labour strike. You know?

Roberta: 100% agree.

Karen: Yeah, for sure.

Joel: Another thing that happens is that American columnists are seeing what’s happening in Saskatchewan and they’re hearing things like, “Oh, Saskatchewan doctors might flee,” and they’re basically arguing, “Should we admit to this country, as desirable aliens, these violators of their solemn oath which requires medical practitioners to abstain from every voluntary act of mischief and corruption?” They’re saying, “Do we want these doctors if they come here? Because they seem really willing to ditch their patients and put them at risk.” Another interesting thing that happens is that many with pro-medicare views in Saskatchewan begin to organize consumer-sponsored clinics like they had done with other cooperatives in the past in times of crisis. So, basically, they raised funds from co-op members to be the salary overhead of a clinic, and this starts to place some pressure on striking doctors because they realize that their economic welfare might be affected by a competing form of practice.

Roberta: What a shocking idea, of taking a service that’s required by the population and moving it into a cooperative into a profit-driven industry, and then that being a problem for the profit-driven side of things. I really, really miss that history of Saskatchewan, of this cooperative movement, of every time they struggled to do something as a rural community, they form a co-op and then challenge the profit-driven motives of the other areas. It’s inspiring to me — let’s set up all these co-ops and put pressure on these doctors! Come on, now!

Joel: Well, they’d managed to take on so many other monopolies in the past, it makes total sense that they’d be like, “Okay, well, we’ll just do a medical co-op. Let’s go for it.”

Roberta: Well, it’s the same principle, right? It’s just on a small scale — the idea of, “Let’s pool our resources. Together, we can pay the salary of a doctor, and then we don’t have to come up with the money every time we have to go visit. And if I don’t have to visit, but you do, I will help support that.” And it becomes more efficient and affordable, and it just makes so much logical sense. So, in that case, it’s doing the same thing but at a small, local level; and then the CCF government’s trying to expand it to this broad level and running into all sorts of hell.

Karen: Dr. Dalgliesh asked permission to address the annual Provincial Convention of the CCF on July 18th, 1962.

Joel: This is incredible to me, and when I was reading about it, I was like, “Why a) would he ask this, and b) would they let him do it?” And I think it’s just because they had let the premier speak to the doctors the month earlier, and so it’s a kind of quid pro quo thing going on.

Roberta: Well, and I think the CCF was legitimately trying to get doctors onside. Like I said earlier, they could have easily just steamrolled this thing through, but instead they really tried. And I think it is partly a quid pro quo, but I also think there really is this sense of, “Let’s bring them in, let’s let them have their say and then convince them to do the right thing.” I mean, I guess it’s maybe a funny thing about the CCF, that they would do this, but they let him come and talk, and lots of people listened to him talk about this.

Karen: Yeah, so, there were over a thousand delegates and visitors present. Dr. Dalgliesh stated that doctors would return to work if the special session of the legislature spelled out that doctors could work outside of the Act. So, we’re not quite sure how that would work, because it was pretty clear what they were expected to do under this new Act, but… So, negotiations resumed over the following days. While many had returned to work after the July 11th rally, the strike was officially over by July 23rd. Doctors finally gave way, accepting a universal, compulsory medical plan.

Joel: Under the settlement, all of Saskatchewan’s 928,000 citizens would be covered under an amended medical care insurance act.

Roberta: I think this is an important part, though. Sorry, I just want to mention the amended medical care insurance part, because I think it does lead to some interesting developments in that what the government caves on, ultimately, is that they set up, basically, an insurance program — so, instead of putting physicians on salary, which was the original plan, it becomes a fee-for-service insurance program that keeps the system of the Blue Cross, Blue Shield organizations that had existed before, to basically become a middle organization through which doctors would be paid. So, the government would pay the insurance company, the insurance company would pay the doctors. And this was supposed to allow the doctors to retain some sort of independence, to not become salaried employees of the state, but I think it also was such an important piece that Woodrow Lloyd and the CCF ended up giving up in this process that has led us to kind of a problematic situation we’re in now. And I know a lot of the fight over the current contract negotiations — I don’t know if we should call them negotiations, but current contract fight — between the AMA and the Alberta government is about salary vs fee-for-service. And I don’t want to suggest that the Kenney government has any leg to stand on in any of this, but it’s interesting that the fight is, again, about salary vs fee-for-service. And what happens is, I think, it creates a more expensive system than what the CCF had originally intended, and it actually is a pretty big compromise that they make to get the doctors finally onside.

Joel: Yeah. It also seems like a scam for insurance companies — like, to continue to act as middlemen in this whole system when, if you’re trying to design a system that works, this is completely unnecessary. Did it actually give more freedom to doctors or whatever? No — to me, it’s just a big bureaucratic mess that siphons off resources.

Kate: So, one of the things I was thinking about when we were researching this episode was — where was all of the pro-medicare organizing in this? What resources did the government put into making sure that people supported the medicare plan that they were implementing? And one thing that I found quite interesting is that the government actually strongly discouraged public demonstrations in support of the plan, and the premier never made any call for support of the pro-medicare program. And that was because — or he claims that was because — he was so worried about the public mood in the province and how intense it was, that he felt that it was very, very close to violence and many people were ready to act in a violent way, and he said that, even to the extent of sacrificing some demonstration of support for the plan, such possibilities — talking here about violence — should be prevented if at all possible. So, he said, “I was at the time, and am still today, of the opinion that, had I said just a few ill-advised words to encourage counter-demonstrations — for example, the time of one or other of the gatherings at Regina — some very unfortunate incidents would have occurred.” So, whether this is just something that he said to save face, or whether this is something that Woodrow Lloyd actually believed, there was the common conception among CCFers in Saskatchewan that, had they encouraged more organizing on their side, it would have led to violence and to hostilities between the two groups. That said, though, letter-writing campaigns to show support were very common, and the premier received mail that was 8-to-1 in favour of the Act. So, it was certainly something that was very, very popular, and I actually think we can see the election campaign that was run before all this happened as the organizing that the CCF did to engender support for its medicare plan.

Karen: Nationwide polls showed that over half the population of Canada were in favour of government-operated health insurance plan. One small community study found 63% support for a government health plan. Many patients didn’t trust their doctors after this. Community health programs and clinics had a broader appeal — so, it’s not the individual so much as a place you’re visiting, a program, and a clinic, so there’s more institutional support and less for the individuals. The CCF would lose the 1964 election, though they retained their vote share and got more votes than the victorious Liberals — so, that’s interesting.

Roberta: Gotta love first-past-the-post.

Karen: I — yeah, still working great. Conservative party leadership didn’t nominate candidates in thirteen rural constituencies, which meant a combined anti-CCF vote.

Joel: Also, by 1964, the CCF had been in power for 20 years, and a lot had changed over those 20 years. They had been doing a lot of this economic development stuff, which meant they spurred on changing internal demographics — like, people were upwardly mobile, for example — which meant being the party of farmer cooperatives was less potentially viable to a middle-class voter. Still, though, they had a 20-year run and ended up introducing medicare, so — pretty good.

Roberta: And in a province that changes government relatively frequently, that’s pretty normal. I mean, 20 years was very, very long for one government in Saskatchewan. It’s only in this weird-ass province that we live in that governments stay in power forever.

Kate: Yeah, it’s extremely Alberta mindset to be like, “Damn, 20 years. What happened?”

[laughter]

Roberta: Exactly. “What a short tenure. What the hell’s their problem? They sucked.” [laughs]

Karen: That’s it. That’s a hugely long run. That’s longer than any government that I’ve lived through, so — in a province —

Joel: Two decades, like, not a bad run, I guess.

[laughter]

Roberta: And if you think about all the changes they did — like, hospitalization and medicare is one thing, but they did so much to change that province in terms of Crown corporations, nationalization of resources, implementation of social programs that get expanded across the country — it really is a fundamentally transformative 20 years. And when Ross Thatcher comes in in 1964, it’s just this idea of something different, and we need a change; and, sadly for Ross Thatcher, they don’t stay in power very long because the CCF — at that point, it’s the NDP, but — they were very, very popular. This was not an indication of the lack of popularity that they had, and anybody that says that their loss in 1964 is an indication that people were opposed to medicare — first of all, doesn’t understand that it’s first-past-the-post that caused this problem of their loss, but also that it was 20 years of one government, and people in other provinces around the country like to change governments every once in a while.

Joel: So, one big question I had when doing the research for this was: why were the doctors so opposed? It’s not necessarily going after their livelihood in any big way — you’re going to continue to get paid, and, if anything, you’re guaranteed to get paid; you’re not going to have to run after patients with unpaid bills or anything. And it didn’t seem to be — like, maybe there’s an ideological component, of the red-baiting and anti-communist stuff going on, but that didn’t really seem to explain the extent to which there was such opposition. And one interesting quote made a point, here, that I unearthed. Basically, when bills were paid for by the Medical Care Commission, the T4 slips went to the Department of National Revenue, and every dollar that they got was on the books — “they” being the doctors — which meant they were paying income tax on it. And apparently, after the next few years after medicare, the per capita income of Saskatchewan doctors was $3000 higher than anywhere else in Canada. [laughs] In the quote, the person making this comment said, “I don’t think they were earning $3000 more, but they were reporting $3000 more.” So, basically, there was perhaps some tax-free income going on, which they didn’t want to see threatened.

Kate: One of the other questions I had when we were doing the research for this was — how did medicare make the leap from this program that was exclusive to Saskatchewan to something that ended up being all across Canada and something that is, frankly, a big — and maybe the only good — part of Canadian identity, particularly considering how much of a struggle it was to have this program implemented in Saskatchewan? And what I learned, that’s actually quite interesting to me, is that all federal parties in Canada moved towards a position of support for a national, state-run plan, and NDP members in Ottawa were basically able to point to Saskatchewan as a success and then were able to, in that way, push the Liberals to move quickly in putting a national plan into effect. And the House of Commons actually approved the medicare bill in 1968 by a vote of 177 to 2.

Roberta: And I think it’s also indicative of the fact that it was really, really a popular and well-designed program, that it worked quite well, that the doctors quite quickly discovered it was not so bad to have this guaranteed income and, as you said, not have to chase after their patients, who were already suffering, to collect bills. It made their accounting systems much easier, and it allowed governments to do all sorts of other planning that dealt with long-term social issues — the Saskatchewan government becomes quite well-known for its research programs at the hospitals in mental health and LSD research, for instance, all sorts of different aspects of this. It opens up possibilities, and I think, by the time it gets to the federal level, people realize, “Oh, wait, this is actually really great for our population; it’s really great to recognize that healthcare is a human right, and it’s actually much more affordable and easy to administer across a broad scale.” I mean, all these social programs are so much more efficient and affordable than everybody trying to do it themselves or bankrupting themselves trying to get the services that they require. And so, I think by this point — 1967, 1968 — people realize that this is actually a really great thing. I think the hard thing that becomes really interesting is that it’s also an issue of federal jurisdiction versus provincial jurisdiction, and the fight sort of becomes about whether a federal government can intervene in what’s really a provincial jurisdiction, of healthcare. But I think the provinces were much happier to receive the funds than to fight over jurisdiction because it then allowed them to do other sorts of innovative programs as well.

Karen: And a lot of the fights between the different jurisdictions came later as a lot of these programs were modified and rolled back. We’ve talked in previous episodes about the 80s and 90s, how that’s much more adversarial, whereas, in the post-war era — as we were seeing on the national stage — there doesn’t seem to be as much friction, and things just seem to make sense at the time.

Joel: Another interesting bit to think about when it comes to discussing medicare is — even in the literature from the ‘60s, ‘70s that I read about this, mentions of expanding it to include dental, optical, pharmaceutical, and mental care is all in this stuff from the 1960s. And it really struck me how much that discussion has just stalled. I mean, it’s mentioned in election years, but very little work is done to move those things forward, and I was curious to see if any of you had any thoughts as to why is it that this has — while it’s this defining part of Canadian identity, etc etc, expanding it has completely stalled.

Kate: Okay, there’s two things about this that drive me absolutely crazy to no end. One is: the lack of these things in medicare is completely fucking insane. The bones in my mouth — if I break my arm, I can go to the hospital, but the mouth bones are these special bones? If I’m not wearing glasses, I can’t see, I can’t work, and I can’t drive, and yet somehow this is considered to be a fun optional add-in to the healthcare system. And, if I go to the doctor because I am sick and the doctor is like, “Okay, I’m going to prescribe you this medicine,” that then costs money. Yes, absolutely, some people do have health insurance provided through their employer to cover these things, but these things are part of healthcare and should not be contingent on having an employer who is giving you those things or being part of a union that has negotiated these things for you. That is completely ludicrous. The second thing that really cheeses me off about this is that it’s very popular, all of these things. Pharmacare has been popular for decades now — something like 95% of Canadians want pharmacare. The vast majority of Canadians, in the case of dental care, optical care, pharmaceuticals, and mental care, physiotherapy, they want this to be included in the healthcare system, and yet it isn’t because the healthcare system that we have is the result of class struggle between capital and bascially everybody else, and capital is decidedly more powerful and wants the ability to be able to profit off of those things. Which brings me to — I lied — the third thing that pisses me off about all this —

[laughter]

Kate: — which is when people will quote statistics about 95% of Canadians being in support of pharmacare or something, as if it’s some great success, when that’s been true for decades and we still don’t have it. For me, that’s actually an indication of a massive failure on our part, because it means that, even though something is extremely popular and extremely desirable by the vast majority of Canadians, we are so atrophied and have so little power that we’re unable to get it. That’s not a cause for celebration, that’s a cause for serious reflection on our tactics and methods for improving our society.

Roberta: It’s so true because, if you think about, almost every election — that I can remember, anyway — has been run on this platform; every party that I can think of — I mean, probably not the Conservatives or Reform, but — the Liberals have been promising for decades to implement pharmacare, childcare, and other sorts of programs. They’ve been promising for decades to implement these programs because they know that they’re incredibly popular — Canadians want these programs, and so they run on these, and they say, “Elect us, and we’re going to expand healthcare,” and then they get elected and they turn around and become the assholes that they are and cut our programs instead. And it is incredibly frustrating because I think a lot of people assume that the electoral sphere is where we can get these big policies implemented, but it proves that more is required; civil society has to rise up to demand these things, because we do vote for it in every election, we do tend to indicate our support in that kind of formal way, but clearly — as you said, Kate — something’s missing; we’re not able to cross that line of pushing the politicians to actually implement the changes that are required and popular. So, what the hell?

Karen: Yeah, it does seem like Justin Trudeau — wasn’t even just during election time, he said, “We’re doing pharmacare,” and that was probably about two years ago. And, again, that was after one of the elections, well into the term, and it was, like, I don’t know where it went, it just vaporized. And that happens pretty often, especially with the Trudeau government, but more generally over the decades, and it’s not just confined to an election promise that doesn’t come true; it’s on somebody’s to-do list somewhere, but when I go to the pharmacy, I’m still co-paying, if I’m lucky, and paying out of pocket if I’m not. And it’s a reality, so.

Joel: Any government that wants to atually implement these things would butt up against the entrenched actors that benefit from the way things are, right? If you want to include dental care in medicare, you’re going to butt up against a bunch of dentists who tend to have profitable practices and are well-resourced, and they’re going to put up a fight, probably like the doctors strike in 1962. Similarly, if you want to take on the pharmaceutical industry, there’s probably an even bigger well-entrenched actor that is happy to make your life hell if you try to threaten them. And so, part of it is probably just that that opposition exists, and then whether governments actually intend to confront those entrenched actors is a whole different question, I think.

Roberta: And also, NDP governments — and CCF governments before them — are far too wimpy once they have an electoral mandate. Like, just do it! They told you to do it, just do it! Be gusty like Woodrow Lloyd and just do it!

Joel: Yeah, that is probably the most depressing thing of talking about all these things, is, like — say, hypothetically, you do end up getting a social democratic government in power. They will drag their feet and go through the most gargantuan process they can imagine to make sure they dot all their Is and cross all their Ts; and it’s like, oh my god, this has been so popular — it’s been popular for decades! People just want you to do it! Please, for the love of God, just steamroll through and make these changes. And they hesitate to do that so much.

Roberta: And yet, the UCP will do it the other way. I mean, they are just steamrolling away as much as they want, you know.

Kate: I was thinking a bit flippant when I was talking about it earlier, but — sometimes strikes are bad. Once, a bunch of dock workers went on strike in the UK because the government fired a racist cabinet minister. Like, that sucks.

[laughter]

Kate: You know? That sucks, right? It’s not a good strike. But, also, dock workers went on strike to not ship arms to Pinochet’s Chile — that’s good. What makes a strike good is not the action, it’s the content of it. But the reason we have overarching rules about, “Don’t cross picket lines, never be a scab,” is because, more often than not, a strike is going to be good because it is going to be undertaken by workers at the point of production who are one of the oppressed classes in our society. That is what makes strikes good more often than not. But absolutely, you can have strikes that are bad and that are undertaken for bad reasons.

Roberta: I 100% agree with you, and I think you framed it really well earlier and now. I think it’s really helpful — it wasn’t flippant at all, actually, I think, your point earlier. I think the hard thing, in some ways, is where doctors fit into this. I mean, I think you made the point earlier really well about them being a professional class, and they’re not the oppressed majority like the workers of the world who need to unite, but they do have organizations that are representing them and negotiating with others. I think the problem I have is that I find it very uncomfortable, supporting doctors in these kind of labour struggles, and yet they also are being attacked by people I think are out for very nefarious ends now. And so I think it puts me in a difficult situation of trying to balance this idea of doctors as professionals and also as workers. And I think that’s where I kind of struggle with this thing in the ‘60s, as well, that — I mean, I can’t believe doctors would walk off the job and refuse to treat their patients because they didn’t want a government-sponsored healthcare program. I just can’t believe that they would give up their ethical responsibilities. But are they workers? I mean, it’s a tricky one for me. But I think you’re right, Kate.

Kate: I don’t want to get to into the whole “Doctors have ethical responsibilities” because that, to me, is a conservative talking point people use to discredit strikes undertaken by healthcare workers — you know, this is something people say to nurses all the time when they go on strike, so I definitely think there are times where, in order to strengthen the service that you provide, sometimes you have to temporarily withdraw providing that service as a way of demonstrating that the service you provide is, indeed, crucial and important, and your labour is what makes it happen. The postal service in Canada, when CUPW goes on strike, is the same way. And, in regards to the question of being professionals or workers — I think, for me, it’s pretty easy to say there are professional workers. Absolutely, is it different to be a worker that has a professional accreditation than to not? Yeah, I think it is, and professional workers do tend to be better paid and have better working conditions — but, you know, nurses and social worker and teachers, they’re all professionals too, and I would absolutely consider them to be workers, and they’ve been at the forefront of some of the most inspiring labour actions in North America over the past decade, right? So I don’t necessarily think that being a professional means that you cannot participate in labour action, particularly considering the way our economies are organized in the global north now. Because of deindustrialization, people who work for a living, the working class, has a different composition here than it does in the global south, period. So, in conclusion, what I have learned from putting together this podcast episode is that doctors in Alberta who are really upset with the government should do exactly what doctors in Saskatchewan did, but make it cool this time and put up signs in their offices that read, “To our patients — this office will be closed after [insert whatever date the AMA picks here]. We do not intend to carry out practice until Jason Kenney reverses his devastating cuts to the healthcare system in Alberta and also expands it to include X, Y, and Z,” since this is a fantasy and I can imagine this. Unfortunately, this will never happen because collective action is so vilified and foreign to people in Alberta that doctors in this province will literally upend their entire lives and move away as individuals rather than organizing as a profession.

Roberta: Well, I think the other conclusion to make here is that social democratic governments — anybody thinking about expanding the welfare state to give further recognition to the human rights that people deserve — access to health, education, food, accommodations, all the things things people require to survive — they should just be gutsy and be like Woodrow Lloyd and actually stand up for what’s right, and who cares about the opposition when they’re jerks? When doctors are jerks, we can ignore them — when they’re on the right side, we will support them.

Kate: So, in conclusion, governments I like should always stand firm and be extremely aggressive in implementing their political program, and governments I don’t like should capitulate on every issue at the slightest sign of opposition.

Roberta: Hear, hear.

Joel: Hear, hear.

Karen: Yep.

Kate: On behalf of everyone here at The Alberta Advantage, take care out there, thanks so much for listening to this episode, and have a good one. Bye, folks!

All: Bye!

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Kate: The Alberta Advantage is supported by listeners like you. Independent listener-supported media like this podcast is possible only thanks to the generous support of our listeners. If you think what we do is important, please head over to patreon.com/albertaadvantage and support our work with a monthly donation.

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