Abstract
Physicians are deeply involved in Canadian medicare because it is through medicare that they are paid. However, from its origins to the present physicians -as a profession - have not been strong supporters of medicare. Fearing loss of income and individual autonomy, they have frequently opposed it with criticisms, strikes, threatened job action and lawsuits. Some opponents are unaware that medicare was a boon to physician income, and many fail to connect medicare with responsibility for improving the health status of the country. This paper will trace physician involvement, support and opposition to medicare from its inception to the present, with special attention to small physician organizations that have supported medicare. It will close with a proposal for how doctors could display greater stewardship.
Highlights
Physicians are deeply invested in Canadian medicare because it is through medicare that they are paid
Some opponents are unaware that medicare was a boon to Canadian physician income, and many fail to connect their participation in medicare with responsibility for improving health outcomes through social determinants and equalizing access to care – that was, and still is, its purpose
Advisors to Ottawa on post-war reconstruction included Principals Robert Wallace of Queen’s University and Cyril James of McGill. But they were interested in equitable health care delivery and the programs used in Russia, an ally in the struggle against fascism
Summary
Apparent, but factitious, drop in the 1990s, owing to the absence of taxation information beyond that date. Represented a projection of the trend in Canadian physician income from the Taxation Statistics source unavailable after 1992 (Figure 2). I bundled up the work and sent it to the CMAJ, which had published the similar, bean-counting research into tuition fees. Doctors are paid from the public purse, they do not have their T4 incomes published on the ‘Sunshine Lists’. I sent the paper to the Canadian Journal of Public Health, which rejected it even more quickly – on the same day – my fastest rejection ever, and without peer-reviewed, claiming that the topic of physician income was ‘unsuitable’ and fell outside its purview.. 3 ‘We can see you have done a lot of work to collect this information and the topic will interest many doctors.
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