Episode Transcript
Episode 32.1: What Tommy Douglas Knew and What We All Know About Socialized Medicine
Matthew Remski: Hello everyone, this is Matthew Remski and this is Antifascist Dad Podcast and here's a follow up on episode 32, which was called Smith and Carney May Destroy Socialized Medicine in Canada with Nikolas Barry-Shaw. It's a brief coda called What Tommy Douglas Knew and What We All Know About Socialized Medicine. I'm really grateful for your support and I hope this project brings some joy and hope and utility to your works and days.
You can find me on Bluesky and Instagram under my name. I'm on YouTube and TikTok as antifascistdad. If you're listening to this as soon as it dropped, you're on our Patreon at antifascistdadpodcast and you have received early access to every second part of the main feed episodes. And if you are hearing this in the unlocked version, you can stay in that stream for as long as you like. I release everything eventually and Patreon is just a way to help fund the show. Also, I want to direct you to a link to purchase my book. It's called Antifascist Dad: Urgent Conversations with Young People in Chaotic Times. And if you've got the book, if you've read it, if you've got the audiobook, if you've got the ebook, please consider giving a review.
Okay, in the six years as the Canadian on staff at Conspirituality, where we analyze conspiracy theories like QAnon that, especially during the height of the COVID pandemic, impacted public health and spun so many people off into right wing politics, I always maintained that QAnon never took root as deeply in Canada because we have socialized medicine. Our entire relationship to healthcare is imbued with the sense of imperfect but basically benevolent governance. There is relatively little reason for Canadians to believe that medical professionals and health officials, with commitments disfigured by capitalism and insurance incentives as they are in the States, are out to kill them.
Here's how I co-wrote about this with my colleagues Derek and Julian in our 2023 book Conspirituality: How New Age Conspiracy Theories Became a Health Threat. At the most intimate level of bodily agency, healthcare, conspiritualists speak to deep cultural wounds. Disability justice activist Beatrice Adler-Bolton came on our podcast to tell us that for decades, normal healthcare policy in liberal democracies has meant rampant neglect exacerbated by austerity and rationing. It's meant a rise-and-grind culture that measures human worth by economic output while shrinking wages and busting unions. It has meant policy decisions dressed up as fiscally responsible that place dollar values on the worthiness of human beings.
We are entitled to as much survival as we can purchase, Adler-Bolton says. In America, a country that spends more than any other nation in the world on healthcare, yet has the highest chronic disease burden of the 38 nations that report to the Organization of Economic Cooperation and Development, the stark brutality of Adler-Bolton's statement is essential for understanding the world that conspiritualism so easily colonized, and it perhaps begins to explain why our focus has been, has had to be, on American influencers and their economies. It makes sense that an empire of predatory for-profit healthcare would incubate a rebellious and religious response to it.
It also makes sense on a visceral level that out of hundreds of DMs, social media comments, and emails we've received from listeners over the past years, the theme that stands out most starkly is that of disillusionment with institutionalized medicine and how that feeling casts a shadow on all relationships with institutions from education to finance to government. For some, alienation from conventional medical care echoed another fracture. They had also been driven towards alternative spirituality by the shadows of corruption in their birth religions. They described the relief of exchanging conventional claustrophobia and hypocrisy for New Age individualism and the permission to self-explore.
Listeners often confided they were driven towards alternative medicine by the brevity and coldness of their clinical encounters, by the feeling of not being seen, or of being seen as a body with a problem instead of as a human on a journey. Research shows that in the US, doctors interrupt their patients within 11 seconds, adding to their frustration with a seemingly inhuman system. And if they suffer from difficult conditions, they describe bouncing from specialist to specialist, each with a narrower view on the problem than the last, none of whom seem to be speaking to each other. They described being prescribed generic antidepressants for complex mood imbalances with a shrug and a pat on the head. Many accounts came from women who spoke of being dismissed by a reflexive patriarchal rigidity that might not take their distress and pain seriously or might pressure them into childbirth interventions they did not want. Some had heartbreaking stories of seeking support for a neurodivergent child for whom one-size-fits-all care would not suffice. For Americans, the allure of alternative medicine also unfolded against the backdrop of possible medical bankruptcy. In an economy that demands underinsured or uninsured patients keep themselves healthy, their credentialed doctors are not simply bearers of unlucky news. They voice the accusing question posed by the culture at large: what have you done to yourself.
Now, had I been the sole author and given the book a more politicized and Canadian socialist point of view, the text would have been more explicit about the capitalism problem at the root of the American public health disaster. I would have foregrounded the antisemitism is the socialism of fools argument from a century ago. I would have foregrounded more prominently that the largely women-led health communications of the Canadian government at multiple levels embodied the caregiving ethos at a moment of peak social stress through the civic ritual of the public briefing during COVID. Dr. Theresa Tam, the Chief Public Health Officer of Canada, was the most visible federal face of the pandemic response. Bonnie Henry, BC's provincial health officer, closed her daily pressers with be kind, be calm, be safe. And Deena Hinshaw, who was Alberta's Chief Medical Officer, did the same through 2020 and 2021 before being sidelined and eventually dismissed by the Smith government.
And I also would have spent more time unpacking the granular details of what socialized medicine actually means to life experience and the capacity to feel solidarity with fellow workers.
In 2012, my partner would have died without an emergency C-section by which she gave birth to our first child. We were firmly ensconced in the yoga world at that time and had planned for a home birth with a licensed midwife and we could do that because it was covered. You see, we're both working-class freelancers and if we had to pay US insurance rates monthly we would be impoverished. Without socialized care, we might have had a financial complication added to the consideration of when to transition my partner to emergency hospital care. When it was clear that giving birth at home wasn't going to work, she needed two nights in the hospital. And if 13 years ago we had left that hospital with a $40,000 or $100,000 debt as well as a newborn and my partner needing to recover from birth trauma, there's no way we would have our current housing or relative physical and mental health. I would not be doing this right now. The amount of extra stress is hard to imagine.
Three years later I was carrying that child up the stairs at the gym and I was strangely out of breath. This was days after returning from Europe on a work trip and I'd also had a strangely sore left foot and a charley horse pain in my left calf. But it was the short breath that scared me enough to go to the ER, where they determined that I had a life-threatening DVT, deep vein thrombosis, which they started to treat immediately. My lungs were filled up with hundreds of tiny embolisms. They showed me on the X-ray. It looked like black confetti.
As a gig worker in the US with no or marginal insurance, I 100% would have delayed going to the hospital. Imagine that. To save money for those who depend on me, I would have chosen to delay treatment in such a way that could have killed me or paralyzed me with a stroke and left my partner with three dependents and no stable income. That is a standard American experience along with medical bankruptcy.
During my DVT ER visit, I had a spiritual experience that wasn't just from the disorientation. In the triage bed beside me, separated by a curtain, the staff were taking care of an unhoused guy who seemed to be having a substance crisis. He vomited, he was crying, he was cursing out the staff, and at one point he stood up and just urinated on the floor. And for whatever reason, I didn't resent him or worry about getting additionally sick because of him. I think the care I had already received made me feel so grateful that I just couldn't think of this guy as being that different from me in terms of vulnerability. And true to their own commitments, the staff didn't treat him any differently either. The same internist who came to interview me about my clot sat patiently with the guy next door to take his recent history, patiently repeating questions that the guy couldn't understand, and then carefully asking for clarification if his answers were not complete. The nurses and janitors swooped in without comment to clean whatever needed cleaning. And I felt nothing but solidarity with this guy because the social relations of care lifted me up and out of my own circumstance and showed me my kinship with him, our shared rights and dignity, and how very few turns of the screw actually separated us.
In my interview with Nikolas Barry-Shaw, we talked a lot about Tommy Douglas, the original socialist prophet of public medicine who brought the first public program to Saskatchewan in 1947 and then worked relentlessly to extend its influence across the country. Nikolas has been reading a 900-page Tommy Douglas biography, I'm reading it now too, and that was to support his reporting on Bill 11, the fight there. And he found it very illuminating as a living playbook for the current moment.
Tommy Douglas was a Saskatchewan Baptist preacher turned CCF politician, that was the socialist precursor to today's NDP. He served as Premier of Saskatchewan between 1944 and 1961 and he implemented North America's first public hospital insurance and then Medicare, despite a brutal doctors' strike. He was later the federal NDP leader. He's the grandfather of Kiefer Sutherland. He was voted the greatest Canadian in a 2004 CBC poll. He also boxed middleweight when he was a young man.
And he understood from the beginning that Medicare had three permanent structural enemies: big business, organized medicine, and the insurance companies. And that the fight was multigenerational, playing out over long timescales. But what struck me most, however, was Nikolas quoting Douglas from a 1984 speech shortly before his death, at a point at which the nation was seeing the first wave of user fees chip away at the principle of single-payer coverage. Douglas asserted that the system could either move forward or it would fall back, but it could never stand still.
He believed that if socialized medicine remained static, merely a system for paying existing hospital and doctor bills, it would eventually be undermined by inevitably rising costs and the political influence of commercial interests. So in his retirement, Douglas emphasized that while removing the financial barriers that he managed to remove through his programming was phase one and really the easiest hurdle, the mission had to proceed to phase two, which in his words were altering our delivery system so as to reduce costs by putting the emphasis on preventive medicine rather than treatment and drugs. Only in that way are we going to be able to keep the costs from becoming so excessive that people will easily be convinced that Medicare is too expensive to maintain.
This is Douglas's essential strategic insight, that expansion is the only defense. And why? Because he realized that socialized medicine is a front in the class war. So his mission had to adapt to the needs of each generation or it would lose the popular support necessary to fend off political and economic attacks from Canadian capital. And he was 100% right.
I have one last story to share about the class war experience at that expansive edge of care. As I've mentioned, our younger son is autistic. And in his situation this comes with extraordinary cognitive skills and also social challenges that make school inaccessible to him. Now I haven't yet mentioned that he is also afflicted with something called PANS/PANDAS, which is a post-viral infection condition. It's sometimes called walking strep, although many different viruses can be involved, and it can cause waves of brain inflammation that can have neuropsychiatric effects. Suffice it to say, this kid who we love with all of our hearts is someone with high care needs, to the extent that my partner has paused her career in psychotherapy indefinitely while we help him, amidst great uncertainty, become the best version of himself.
Tommy Douglas said over 40 years ago that expanding universal healthcare into full mental health coverage was necessary, or else capitalism would both claw back all gains. But also, he knew that if you extended coverage, you extend the sense of solidarity between people through a shared project. As it is now with our son, nothing has been more radicalizing than seeing how he is constantly at the edge of social exclusion, barred by systems that cannot accommodate him or understand his brain in ways that help unlock his creativity and that stand with him in solidarity.
And I've been helped in this beyond measure by Robert Chapman, who in his amazing book Empire of Normality, argues that neurodivergence, including autism, ADHD, dyslexia, and so on, is not a natural medical category, but also a product of industrial capitalism's demand for cognitive standardization and productivity. And so what gets pathologized is whatever falls outside the norms required by wage labor. Neurodiversity is therefore a class and political question, and not only a clinical one.
And while the altruism and brilliance and humanity of healthcare workers over the decades has made so much progress in understanding neurodivergence, capital is pushing back as hard as it can, not only economically with austerities on school systems, but also on the cultural level. And we see this with right wing politicians supporting antivax propaganda that pathologizes autism. We see it with RFK Jr. claiming that autistic people didn't exist when he was a kid. We see it with pseudoscience like the Telepathy Tapes going viral. It's a peak bourgeois contradiction that at the very point that our productive forces have allowed the best understandings of autism we have ever had, the economic forces that support this intellectual and clinical work are also disfiguring it in the name of profit and the need to discipline everyone into higher productivity.
So for three years I have watched in granular detail the institutions of our country tell my son, we don't have the will to really take care of you. And I think the liberal part of my brain, however shrunken it now is, is trained to concede, to say, well, you know, you've got a point. He really does have a lot of challenges. No system can work for everyone. I guess we'll just have to manage. And that part of my brain just spits that out without any effort. But it's dead wrong. Because according to that logic, what's the next domino? The next domino is any other part of complicated healthcare suddenly re-envisioned as open for debate, perhaps too expensive, perhaps better attended to privately because we're all so unique, right? Tommy Douglas was right. If you don't expand the circle of care, the capitalists will have a fixed target and a population that has acclimatized to the benefits so well that they don't realize they have to fight to retain them.
Now, my son's story is his to tell if he wants to. But I'm going to offer one observation about how he has come to understand his class position in his society, or at least how I observe it. At ten years old, he sees himself in solidarity with the poor, the depressed, people with substance issues, people without shelter. But it's not just solidarity, it's also vigilance. He's looking out for people.
One day we were driving back from an outing and we passed by this grassy hill and we both saw a guy lying down in the sun with his dog beside him. This must have been 200 yards away at least. I didn't think twice. I mean, I was driving, I was watching the road, but it didn't really stop me up. But my son, his head turned and followed the sight and said, dad, I don't think he's okay. And I asked him why. Well, he's lying funny, like he's ragdolled. And so he knows ragdoll physics from video games. And I said, was he? Yeah, I think he's face down. I think we should go back and see if he's okay.
So I turned the car around and I had to park up on the sidewalk with the flashers on because it was a no-stopping zone. And we climbed up the hill together and sure enough, the guy seemed unconscious. He was face down in the baking sun. He was wearing too many clothes for the weather, as if he's in the situation where he has to take his clothes with him. And he's got this confused German shepherd who's sitting close by. And I spoke to him and he started to rouse himself and we offered water and I said, I really want to phone an ambulance for you. Do you think I can do that? Would you like me to do that? And he kept saying he didn't want the cops to come. And so when I phoned the ambulance, I said that. And the dispatcher seemed to take that as a note from me, although I don't know what their protocol is. So I was worried that the cops were going to show up before the ambulance and I would have abused this guy's trust. But nobody came. We waited there for ten minutes. We kept talking to the guy. There was no ambulance. And as we talked, he seemed to clear himself a bit. He was able to bring himself upright and then to stand up. And then he thanked us, and he said he could walk home. And on he went, a little bit unsteady, but he went off to wherever he was going.
And back in the car, my son and I had a long talk about the many ways in which a person could fall on hard times like that and what people really need and why the guy was concerned about the police coming. And so we talked about all of that. But then I told him how proud I was, how impressed I was that he saw something was wrong and that he insisted that we stop. And he just said, I don't understand why no one is taking care of him. He's just a person like us.
So here's to Tommy Douglas, socialists the world over, my partner and my son. Take care of each other.
