Complex Case

The bare outlines of the story are the mother’s milk of Canadian identity: Tommy Douglas, the plucky premier of Saskatchewan, staring down his province’s combative doctors and establishing a pioneering system where people could get medical care without having to open their wallets.

The tale is true — as far as it goes.

On June 15, 1944, Douglas’s Co-operative Commonwealth Federation won election in the impoverished prairie province, largely on the promise that it would bring primary health care within the financial reach of ordinary people. In office, where he was both premier and health minister, Douglas quickly set up North America’s first single-payer hospitalization insurance scheme. Now patients had only to flash a card to receive treatment in an institution. Later, in 1962, a few months after he left Saskatchewan for Ottawa to lead the New Democratic Party, Douglas’s successors in the CCF government endured a strike by feckless doctors and...