Discussion Guide

Discussion Guide: Key Questions for Discussion

Use the Key Questions below to encourage discussion about each time period described in the Making Medicare:  The History of Health Care in Canada, 1914-2007.

Origins, 1914–1929
Key Question: What role should the federal government play in social welfare activities?

Depression Developments, 1930–1939
Key Question: Should government or the private sector develop and administer health insurance, or should Canada adopt “socialized medicine”?

National System, National Failure?: War, Reconstruction and Health Security for Canadians, 1939–1948
Key Question: Why was Canada unable to create and implement a national plan similar to the British National Health Service proposal?

Private or Public? Voluntary or Compulsory?: Hospital Care for Canadians, 1948–1958
Key Question: Why was hospital care the first component to be implemented at the provincial and federal levels?

Conflict and Compromise: Creating the Medical Care Act, 1958–1968
Key Question: Why did Canadians support medicare when doctors’ organizations and the insurance companies opposed it?

From Cost Control to Health Promotion: Implementing Medicare, 1968–1978
Key Questions: Why was a new vision of the determinants of health needed? Why was the health field concept so slow to be adopted?

Saving the System: The Canada Health Act, the Ottawa Charter and Achieving Health for All, 1978–1988
Key Questions: Is the concept of medicare as a national icon a myth?
How and why did it become a component of national identity during the 1980s?

The Endless Challenge: Balancing Change and Continuity, 1989–2007
Key Questions: What features of medicare have changed since its introduction? How have Canadians’ attitudes to medicare changed since 1990? What impact have all the provincial and federal studies of various issues had on resolving systemic problems? Did health promotion activities open new approaches or are the determinants of health beyond the scope of federal and provincial health ministries?

Conclusion: July 1, 2008 marked the fortieth anniversary of the implementation of the Medical Care Act
Do Canadians recognize the health care system that their governments fund and administer? What has remained the same? What has changed?
Are the values on which the programs were based still widely shared?
How greatly has demographic change modified Canadians’ expectations of health care providers, governments, health promotion and personal responsibility?