Cover image for This may hurt a bit : reinventing Canada's health care system / Stephen Skyvington ; foreword by Dr. Brian Day.
This may hurt a bit : reinventing Canada's health care system / Stephen Skyvington ; foreword by Dr. Brian Day.
Publication Information:
Toronto : Dundurn, 2019.

Physical Description:
245 pages ; 23 cm
"'How might we fix Canada's health-care system?'; 'Why would we want to?'; and 'What's stopping us from doing so?' These three questions lie at the heart of this in-depth exploration of one of the biggest political and personal issues facing Canadians. This book explains why change must occur, in light of the implications of embracing the status quo and doing nothing, and describes how Canadians need to get engaged in order to save our health-care system. This May Hurt a Bit is meant to provide a blueprint for change once those in charge finally acknowledge that most inconvenient truth - namely, that Canada's health-care system is in poor health."-- Provided by publisher.


Call Number
Material Type
Home Location
362.10971 SKY Book Adult General Collection

On Order



Some painful news: Canada no longer has the best health-care system in the world.

How might we fix Canada's health-care system? Why would we want to? What's stopping us from doing so? These three questions lie at the heart of this in-depth exploration of one of the biggest political and personal issues facing Canadians.

Skyvington explains why change has to occur, in light of the implications of doing nothing, and describes how Canadians can and must get involved to save our health-care system.

This May Hurt a Bit is meant to provide a blueprint for change once those in charge finally acknowledge the most inconvenient truth -- namely, that Canada's health-care system is in poor health.

Author Notes

Stephen Skyvington is one of Canada's pre-eminent political pundits and health care policy experts. His columns regularly appear in newspapers across Canada. He lives in Cobourg, Ontario.



Canada, as a country, has always been somewhat star-struck. Maybe it'sbecause Canadians are, as a whole, so gosh-darned polite and humble. Ormaybe it's because we have such a massive inferiority complex we only feelvalidated if someone bigger and more important than us, say, someonewith a huge international profile like U.S. senator and former presidentialcandidate Bernie Sanders, decides they need to start paying attention towhat we're doing. In the case of Senator Sanders, he made a much-ballyhooed trip toCanada in late October of 2017 at the invitation of Dr. Danielle Martin,vice-president of medical affairs and health system solutions at Women'sCollege Hospital in Toronto, and Kathleen Wynne, premier of Ontario. Dr.Martin, who became a YouTube sensation in 2014 by taking on a Republicansenator during a widely publicized appearance before a partisan U.S. Senatecommittee looking into the Patient Protection and Affordable Care Act(a.k.a. Obamacare), had recently published a book, entitled Better Now: SixBig Ideas to Improve Health Care for All Canadians, in which she suggestedthere was nothing seriously wrong with Canada's health care system that aLiberal dose of socialism (i.e., boatloads of money taken from the pocketsof unsuspecting taxpayers) couldn't fix. Not surprisingly, the good senator,himself a dyed-in-the-wool socialist, was quick to latch onto Dr. Martin'snonsense. Like something out of Mr. Smith Goes to Washington, or perhaps astrange and baffling episode of The Twilight Zone, we were treated to sceneafter scene of Senator Sanders being taken from one health care centre to thenext -- events all carefully orchestrated so that the beaming senator couldwitness one miracle after another. I couldn't help thinking how terriblyappropriate it was that this truly naive and easily led visitor from the southhad chosen to make his pilgrimage to Canada so close to Halloween. It wasas if Dr. Martin and Premier Wynne were taking young Bernie door to door,smiling like Cheshire cats as he received treat after treat, which the little boysquirrelled away in his satchel so he could take each piece of candy out andsavour it once he got back home. Watching all this unfold, hour after hour, day after day, thanks in partto our ever-accommodating media, who apparently are incapable of askingprobing, tough questions, I began to feel sorry for Sanders. Here was aman who'd built a reputation as something of a straight shooter, that rarebreed of politician who actually cared about the truth, one who said whathe meant and meant what he said. Sadly for Senator Sanders, he was beingshowered with "treats" by two used-car salespersons, who appeared to haveno qualms about "tricking" the senator into believing that Canada has oneof the best, if not the best, health care systems in the world. Never mindthe shortages of doctors, nurses, and pharmacists. Never mind that manyof our emergency departments are now operating well above 100 percent oftheir capacity, which has resulted in patients being stacked up on gurneyslike so many planes on a runway, waiting for takeoff. And for God's sake,whatever you do, don't you dare mention wait times. After all, being a childof the 1960s, Bernie is not a young man anymore. We don't want to givehim a heart attack. If I'd been asked to meet with Senator Sanders, here's what I would havetold him: "In order to know where you're going, you have to know whereyou've been." Now, lots of people think they know how Canada's health care systemcame into being. "Tommy Douglas, the former premier of Saskatchewanand one-time leader of the New Democratic Party," they'll tell you, "was thefather of Canadian medicare." They're wrong, but that's what pretty mucheveryone in this country has grown up believing. So much so that in a pollconducted by the Canadian Broadcasting Corporation in 2004, Douglaswas named the "Greatest Canadian." Even more believe that they, and theyalone, know what's in the Canada Health Act. They'll swear up and down,for instance, that one of the five principles of the act says medicare must bepublicly funded. In fact, it says that medicare must be publicly administered.There's a big difference. This has resulted in Canada's health care landscapebeing littered with so much unhelpful rhetoric it's a wonder anyone can seethe forest for the trees. To help cut through some of this clutter, I thought it might be a goodidea to look back at how we came to find ourselves in the mess we're inwhen it comes to health care. To this end, I'm going to focus on five thingsI believe were seminal in the building of our health care house of cards herein Canada, where it's become only too easy to fool ourselves into believingwe do indeed have the best system in the world, even though the truth isfar from that: Tommy Douglas and the Saskatchewan experiment; the HallCommission and the introduction of medicare; the Canada Health Act;the Savings and Restructuring Act; and the Commitment to the Future ofMedicare Act. Starting with Tommy Douglas and the Saskatchewan experiment issomething of a "no-brainer," of course, even if Douglas really wasn't medicare'sfather. After all, without this bold early attempt, it's entirely possiblethe rest of Canada's provinces might never have been convinced to diptheir collective toes into the healing waters of medicare. Likewise, a closerexamination of the mid-1960s commission overseen by Justice EmmettHall is in order, if for no other reason than to show there were just as manyCanadians against the creation of a national health care system as there werein favour. Which brings us to the Canada Health Act. While many feel theCanada Health Act has been something of an albatross around our necks,the very thing that's been stifling innovation and creativity and ultimatelypulling us down these past thirty-plus years, the fact remains that its introductionwas, without a doubt, one of the most important moments in ourcountry's history. Finally, I'll take a look at two pieces of legislation thathad big impacts here in Ontario when they were introduced and are stillaffecting our health care system today, as other provinces (Alberta, Quebec,and British Columbia, in particular) have gone on to bring forward theirown versions of the bills. The Savings and Restructuring Act was brought inby the Mike Harris Conservatives in 1996, as part of their Common SenseRevolution. The Commitment to the Future of Medicare Act was the workof George Smitherman, Premier Dalton McGuinty's first health minister,after the Liberals defeated the Progressive Conservatives in 2003. In someways, both of these pieces of legislation have had an even bigger impact onthe health care environment in Ontario, and, indeed, in the rest of Canada,than even the Canada Health Act. Excerpted from This May Hurt a Bit: Reinventing Canada's Health-Care System by Stephen Skyvington All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.