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MEDICARE

Editor’s note:

WILL THOSE OPPOSED
e e oe PREVENT ITS IMPLEMENTA

The news that medicare — the biggest political football in the nation’s history
— will come into being in the provinces of Saskatchewan and British Columbia on July
I, is a matter for rejoicing by those who pressed for this enlightened social legislation.

However, this rejoicing could be short lived if those in opposition to medicare are
successful in their present intensive campaign to prevent its implementation.

To acquaint its readers with some of

the problems involved in implementing a

medicare programme, the Lumber Worker is running the following articles from two

labour officials, both of whom are familiar with the subject through their years of serv-
ice as labour M.S.A. representatives.

By EARL KINNEY
President of the L.P.I.U. Local 210,
Past Labour M.S.A. Representa-

tive and Former President

Medicare is probably the
most controversial subject in
Canada today, taking prece-
dence over such major issues
as the revised constitution of
Canada, the separatist threat
of Quebec and Bicultural and
Bilingualism. It may have a
major impact on the choice of
the new leader of the Liberal
Party. The news media may
not reflect that position at this
time but rest assured that the
statement by the Prime Mini-
ster that Medicare would be
implemented on July Ist, 1968
was the starting gun for the
climatic campaign in opposi-
tion to it:

What is It?

What is medicare and why
is it so controversial? Most of
us are not too familiar with
the Legislative Act which sets
out the terms and conditions
under which it will be imple-
mented. A great number of
people in British Columbia
though, are familiar with pre-
paid medical plans. Medical
Services Association (MSA)
is an outstanding example for
thousands of people in B.C.
of how a non-profit prepaid
medical plan can and has pro-
tected them from large and
yes, even disastrous financial
loss from medical expense. It
is with this in mind that we
are prompted to seek and
support a National Medicare
program which will provide
medical care for all Canadians
wherever they work and live
or their financial position in
our society.

Welfare State

Among those who are most
familiar with the terms and
conditions set out in the
“Act” are the Actuaries, Con-
sultants, employees of Insur-
ance Companies that are en-
gaged in providing insured
prepaid medical coverage and,
of course, the Medical Profes-
sion. It should not be difficult
to understand that the large
majority of those people will
be opposed to the National
Plan because of their vested
interest in the status quo.
Among the many reasons put
forth by. this group for not
implementing Medicare is the
all inclusive phrase “Welfare
State”. This of course is an
attempt to associate any social
reform with Communism. _

It is my opinion that Medi-
care will be one of the great-
est social reforms of our time.
There will probably be weak-
nesses that will require study
and correction, but as with
other social reforms, if the
will is there to make it suc-
ceed, it will succeed.

It is estimated that the plan
will cost the Canadian Citizen
a reasonable amount of
money and he will pay for it
by means of taxation or a

EARL KINNEY

combination of taxation and
premium. It will not be some-
thing for nothing, and will
probably cost the average
person approximately the
same amount as he or she
pays for comprehensive pre-
paid medical coverage now.

“The plan is designed, how-

ever, to provide for medical
attention for ALL Canadian
citizens, to be portable in
Canada and to be paid for on
the basis of ability to’ pay
rather than the present sys-
tem of requiring every person
to pay a stipulated “premium”
regardless of his or her ability
to pay.

The concept of National
Medicare, one prepaid medi-
cal plan for all of Canada, is
not only a great social reform,
it will exemplify the principle
of a broad economic base. The
principle of funding insurance
of all kinds on a broad eco-
nomic base has been funda-
mental to that industry, using
the money provided by the
premiums of those who have
no claims to pay for those who
do. If a company or plan were
to insure only ten people and
all ten had claims in excess
of premium, then the “carrier”
would be forced to abandon
the field. Should the company
or plan, however, insure ten
thousand people the probabil-
ity of all having claims in ex-
cess of premium would be
greatly minimized, -The Na-
tional Plan, of course, pro-
vides for medical coverage
for millions of people with the
resulting “risk” substantially
reduced.

National Medicare has one
other feature that I believe is
favourable to the majority of

people in Canada. Should a
bad experience occur in any
given year, Medicare can
meet the increased cost from
general revenue, which is
provided by taxation. Any
deficit created by such experi-
ence by the plan will be met
by those most able to pay and
those in the lower income
bracket who would be unable
to pay would not be denied
participation in the plan as
would be the case in a private
plan.

Little Control

The present insured pre-
paid medical plans and even
larger plans such as MSA,
B.C. Medical and CU & C
have little control over medi-
cal costs. Negotiations do take
place between the Medical
Profession on the one hand,
and MSA and B.C. Medical
on the other, over increases
to the medical fee schedule.
It is a matter of opinion as
to whether these are success-
ful from the standpoint of
the public interest. In any
event the fee schedule is not
the entire governing factor in
the cost of medical care to
the prepaid medical plan or
the uninsured person. One of
the greatest contributing fac-
tors to the heavy cost of medi-
cal care is utilization. The
connotation of this term im-
plies that the responsibility
for excessive utilization is en-
tirely that of the insured
member. This is not so. To a
great measure the Medical
Profession or a large segment
of it is responsible. It is no
secret that the method of
practise, by the medical pro-
fession, has changed substan-
tially since prepaid medical
plans became the source of a
large percentage of their in-
come. Many doctors are see-
ing their patients far more
frequently than in the past
and the increased utilization
created by this is, in large
measure, the responsibility of
the doctor.

Enough Doctors

The statement, by that pro-
fession, that there will not be
enough doctors to provide
adequate medical service ap-
pears as a scare tactic, or a
threat when one remembers
that the people of Saskatche-
wan managed when the doc-
tors withdrew their services
in an attempt to defeat medi-
care in that province. There
have been shortages of skilled
labor, professional people, and
scientists at various times in
the past, yet our society has
managed to overcome the
shortage. So much so that we
have experienced an over
supply in all of those fields at
one time or another. If the
statement is to be considered

THE WESTERN CANADIAN LUMBER WORKER

seriously, then it points up
very clearly that the need for
Medicare is great, as a large
number of our fellow men
must be at this time without
access to medical care. It
would also indicate that the
number of doctors available
are just sufficient to provide
service for those who are fi-
nancially able to pay for their
services at rates that are es-
calating far more quickly
than is the purchasing power
of the majority of the Cana-
dain people.

Medicare is no bogey ex-
cept to those of the establish-
ment with vested interests. It
is the instrument that can
provide social equality for all
Canadians as far as medical
care is concerned. The day
has passed when anyone can
consider medical care as a
luxury for the privileged few.

TO |

We are 4 the Se cen-
tury and in Canada every
person must be entitled to
medical care without the
threat of personal bankruptcy
because of the extreme cost of
a serious illness or major
surgery.

As mentioned at the outset,
the political pressure against
National Medicare by the
vested interests will now go
into high gear. Extreme effort
and large sums of money will
no doubt be spent in an effort
to either kill the program,
modify it or delay its imple-
mentation.

Support the campaign to
have “Medicare” a reality in
Canada in 1968. Write or send
a card to your Member of
Parliament signifying your
support. Most important of all
DO IT NOW.

THOMPSON PREDICTS
HOW PLAN MAY OPERATE

By BEN THOMPSON
First Vice-President of Local 1-71,

IWA (President, Medical Services
‘ Association)

The slow road to national
medical care is now taking
another step forward. Decem-
ber 8th, 1966, Parliament ap-
proved Bill C-227. This Bill
commits the federal govern-
ment to paying half the na-
tional average cost of provin-
cially administered medical
care plans with the following
conditions:

1. Operated on a non-profit
basis by a public authority
subject to provincial audit;

2. Makes available insured
services on uniform terms
and conditions to all resi-
dents of a province;

3. Covers not less than ninety
(80%) per cent of the total
insurable residents of the
province (to increase to
ninety-five (95%) per cent.

4, Full coverage of services
after three months’ resi-
dence in province, and
transfer provision to other
provinces.

The recent announcement
that the Province of British
Columbia will participate in
the National Medicare pro-
gram immediately poses the
question “What happens to my
existing medical coverage?”
The answer appears to lie in
the legislation passed last year
in Victoria which empowered
the government to audit pri-
vate medical plans in the pro-

BEN THOMPSON

vince. ‘This indicates that
M.S.A., C.U. & C. and other
non-profit medical carriers
will likely continue their role
of providing group medical
coverage and that the B.C.
Medical plan will continue to
provide coverage to individ-
uals not eligible for group
coverage. Formal announce-
ment is yet to be made by the
Provincial government on ap-
proved carriers and the uni-

form coverage of services and
conditions.

SSS ey

MEDICAL PROFESSION
STILL IN DARK AGES

The spokesmen for medical
organizations sometimes make
rash statements in their oppo-
Sition to medicare, but few
in recent years have been so
rash as view of the president
of Ontario Medical Associa-
tion that medicare is making
Canada “communist.”

In a talk to the Junior
Board of Trade in Toronto,
Dr. W. J. S. Melvin, OMA

President, was quoted as say-
ing: “I don’t believe we are
living in a socialist country,
I think we are living in a
Communist country.”

Dr. Melvin’s charges got
such nationwide coverage that
it provoked federal health

and welfare minister Allan — ‘Mf
MacEachen to issue a rejoin- ie

See “MEDICAL” —Page 7

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