Nearly 50 years before Sarah Palin gave us "death panels," the American Medical Association was testing the limits of health care scare tactics in the Canadian prairies. During the 1960 provincial election in Saskatchewan, the AMA helped fund an advertising campaign aimed at defeating the Co-operative Commonwealth Federation, a quasi-socialist party whose leader, a former Baptist minister named Tommy Douglas, had promised to introduce universal, government-funded health care in the province.
The AMA, together with Saskatchewan's College of Physicians and Surgeons, warned that if the CCF won, doctors would leave the province in droves. But here was the kicker: As Dave Margoshes writes in his 1999 biography of Douglas, the campaign told voters that if the state were permitted to take over health care, "patients with hard-to-diagnose problems would be shipped off to insane asylums by bungling bureaucrats."
The campaign failed. Douglas won the election, and the CCF government went on to introduce his health care plan in 1962, creating the model that the rest of Canada would later follow. (So far as we know, insane-asylum panels did not come to pass.) But the fight for health care reform in Saskatchewan, which the AMA worried could spark change in the United States, was a precursor to the battle in America today—a mix of populist anger, political opportunism, and disinformation. As Democrats debate whether to pursue health care reform in the face of growing opposition, they might consider the lessons of Saskatchewan.
Like the Democrats after their 2008 victory, the CCF moved slowly at first to implement its plan, a delay that emboldened the opposition. In an attempt to win the support of doctors, the government created an advisory panel for their concerns. Doctors used the panel to stall, and the government waited more than a year to pass its reforms, with the start date delayed until July 1, 1962. The province's doctors responded with a vote to strike if the plan was implemented.
The events of the next 10 months were ugly by Canadian standards. Douglas' push for health care reform "lit the fuse of the incendiary bomb that would tear Saskatchewan apart into its two opposing elements," wrote Doris French Shackleton in her 1975 biography of Douglas.
Part of the unrest came from doctors themselves. In the months leading up to the new plan, physicians across Saskatchewan put up office signs reading, "Unless agreement is reached between the present government and the medical profession, this office will close as of July 1." Douglas' wife, Irma, described how a doctor would tell his pregnant patient, after a check-up, "I'm afraid this is the last time I'll be able to see you."
The doctors' worries about being paid by the province, rather than patients, may have been genuine. But those concerns were amplified by Saskatchewan's opposition Liberal Party, which had been shut out of power since 1944. Like the American Republicans 50 years later, the Liberals fought health reform in two ways: directly, by opposing it in public; and indirectly, by supporting groups that could provide the appearance of broad-based public anger. In Saskatchewan, the public opposition to health reform came in the form of a movement called Keep Our Doctors, which organized rallies and protests across the province.
Sometimes, the Liberals blurred the line between political opposition and rabble-rousing. At a Keep Our Doctors rally outside the provincial legislature, Liberal leader Ross Thatcher used the occasion to call for a special session of the legislature, which wasn't sitting at the time. To illustrate his point, he invited TV cameras to follow him up to the locked doors of the legislature, which he then made a show of trying to kick down.
But in another precursor to today's Tea Party movement in the United States, the unrest over health reform in Saskatchewan proved to be more than just political theatrics. "The fears inspired by the doctors and fanned by the Liberal party," Shackleton writes, "convinced many people at least briefly that the CCF was a dictatorial, power-mad, ruthless group of politicians who would rather see people die for lack of medical care than back down." Shackleton described "a sense of civil war." (Read more about the unrest in Saskatchewan.)
Public anger against the plan found its lightning rod in Douglas, who had resigned as Saskatchewan's premier to run for federal office as the member of Parliament for Regina. Election Day was June 18, 1962—just two weeks before the new health care plan was to take effect. A woman who worked on Douglas' election campaign recalled the venom of the time. At night at the campaign office, "teenagers would come up and hiss at us through the glass," she remembered later.
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