Medicare’s scrappy defender

Every eye at the Canadian Auto Workers’ 1999 collective bargaining and political action convention focused on the giant screen as the image of Tommy Douglas, the Saskatchewan premier who promised and delivered the first publicly funded, universal health care in North America, began speaking. The brilliant orator believed utterly that health care should be available to everyone, regardless of ability to pay. But in this speech recorded in 1983, three years before his death, Douglas warned that medicare would be slowly strangled unless Canadians raised their voices forcefully. He couldn’t know that 16 years later, his daughter, Shirley Douglas, the guest speaker at the CAW event, would be a key defender in the battle to keep Canada’s cherished health-care system from falling apart or slipping into private hands.

Tommy Douglas understood what lack of money meant when medical care had to be purchased. As a boy in Scotland, he’d had a bone infection that might have ended in the loss of a leg had a kind doctor not intervened. Later, during the Depression years in Weyburn, Sask., one of the goals of the young Baptist minister-turned-politician was to provide access to health ca for everyone needing it. “My father had never thought about going into politics,” says Shirley Douglas, “but the situation was desperate and he began to realize the whole concept of changing society through a church was just not going to be sufficiently powerful to really make a difference.”

As an impressionable 10-year-old, Douglas accompanied her father during the 1944 election, when his Saskatchewan CCF (Co-operative Commonwealth Federation) party successfully campaigned to provide hospital insurance for all the province’s citizens. In dusty community halls where the prairie wind breathed around windows and doors, she witnessed the pain of rural people whose lives were devastated by accident or illness because there was no money to pay doctors or hospitals.

It was a nasty election. After a political meeting, they would find the car adorned with swastikas or with the tires slashed. She recalls seeing her father, a champion flyweight boxer in his youth, smash a glass jug at a meeting and tell a threatening man, “Don’t you come a step closer!”

But by 1947, the hospitalization plan was implemented – and popular. Physicians’ fees outside hospitals would not be covered until 1962, after a bitter 23-day doctors’ strike. American and Canadian medical associations and insurance companies saw Saskatchewan as a beachhead for state-run medicine that would threaten their autonomy and profits, and they backed the doctors. “The government was really struggling with the huge insurance companies, the big health-care conglomerates – the same people undermining it now,” charges Douglas.

An intimate knowledge of medicare’s birth and a willingness to speak out lends her unique authority. “Politicians tread very carefully when dealing with Shirley Douglas on medicare,” says Michael McBane, executive director of the Canadian Health Coalition, who invited her to become the national spokesperson for the CHC five years ago.

A family of fighters
Seeing her parents persevere and succeed in achieving something as socially significant as public health insurance has kept her a lifelong optimist. “That was one thing my father was determined to figure out how to do,” she says. “He felt it was immoral for anyone to be ill and not have access to the medical help that could be given. And he knew if he organized it, everybody could be covered.”

Her mother, Irma, was quietly observant, funny and self-reliant, a useful trait with a politician husband who was frequently away from home. “She was a darling,” says Douglas smiling affectionately. “She was extremely bright and very Irish. My parents worked very well together.”

Next page: Capturing the audience

They also didn’t lecture, had faith in her judgment and supported her growing interest in theatre. “My father used to say, ‘There’s no point working this hard if you’re not going to be able to afford beauty and art and things that are really important.'”

They let her go off to the Banff School of Fine Arts for two summers with a flamboyant neighbour and her two children. “Mrs. Goldman was always doing wonderfully colourful things,” she laughs. “She had a big Spanish shawl and a nude on the piano. I thought, ‘This is a very fun house.'” At Banff, Burton James, a superb director from the Seattle Repertory Playhouse, recognized her talent. Sadly, he died in prison after refusing to testify against anyone during the McCarthy era.
Douglas’s acting career began modestly, with a role in Regina’s little theatre entry in the 1950 Dominion Drama Festival. This earned her a best actress award and an invitation to Britain’s prestigious Royal Academy of Dramatic Arts. It also marked the beginning of a distinguished career that would eventually include stage, film, television and radio in Canada, the U.K. and the U.S. On stage she’s appeared as Hagar Shipley in Margaret Laurence’s “The Stone Angel”; Marilla in “Anne of Green Gables”; and played Laura in the creepy feature film “Dead Ringers.” In 2000, she won a Gemini award for her performance in the TV film “Shadow Lake.”

Her resonant, polished voice commands attention. At the CAW convention, for example, one of her first appearances in support of medicare, she was at ease, dignified, authoritative and, at times, humorous or forceful. The audience was fascinated, rewarding her with a standing ovation.

“I have a big voice because I use my diaphragm,” says Douglas. “When I was very, very young, my father taught me how to breathe. He had this enormous breath capacity. He could speak out in the wind, and you would hear him.”

Imposing image and organizational skills
The strong, often angry women Douglas portrays on television, film, radio and stage leave audiences with an impression she’s imposing and intimidating. It comes as a surprise to find that, face to face, Douglas is tiny. At 69, her skin is beautiful and virtually line-free. Instead of the controlled waves of May Bailey, the matriarch she plays on CBC-TV’s “Wind at My Back,” her slightly curly, ear-length hair softly frames her face, falling across the left side of her high forehead. She ruefully blames the TV series for the fact that she’s currently dieting. Film crews are fed well and often, she explains. During six months of mostly midwinter filming, she says, “You get beyond tired and then you start to eat. You think it’s giving you all kinds of energy, but then the costumes start to fit not so well.”

Beyond her celebrity and family connection to a health-care philosophy Canadians value, Douglas is respected for her knowledge of health-care matters and her organizing abilities. “My mother was a great organizer, and I got that from her,” she says. “In the anti-war movement [in California], someone asked me to give lessons on how to work the phone. I couldn’t. But I know that if you tell me to have a rally ready for a date, I will have it done.”

Douglas also confesses her mother once said her daughter’s only problem was that she never learned to be afraid, something she attributes to observing her father speak out on all sorts of issues. “When the health situation started to fall apart here, it made me so angry I could hardly see straight. I couldn’t ignore it,” she says.

Next page: The price of supporting the underdog

Willingness to stick up for the underdog sometimes has a price. In the late 1960s, during her marriage to actor Donald Sutherland, Douglas became active in the civil rights and anti-war movements in Los Angeles. Fundraising for a Friends of the Black Panthers’ breakfast program for children led to an arrest by the FBI, who charged her with conspiracy to possess unregistered explosives. The allegation that she wrote a cheque to buy grenades was soon found to be false. Her father, then leader of the national NDP, flew to L.A. to lend support. “He asked if I would mind if he came down,” she recalls. “He wanted to be sure I had a good lawyer. If I had said no, he wouldn’t have come. He was a hugely sensitive man.”

A celebrity son shines
Today, Douglas isn’t alone in working to keep her father’s legacy thriving. Movie-star son Kiefer Sutherland, 36, lends his fame to the health-care fight, occasionally appearing with her at public engagements, even recording a radio ad urging Prime Minister Jean Chrétien to adopt the recommendations of the Romanow report, which was released a year ago.

Recently, his life has been consumed by the demands of “24,” the hit TV series he co-produces and for which he received an Emmy nomination for his role as agent Jack Bauer. He’s hoping that during the show’s hiatus next spring he’ll portray his grandfather in a four-hour, two-part production for CBC-TV. Sutherland, 19 when Tommy Douglas died, has always wanted to film the politician’s story. His mother, creative consultant on the project, has already begun collaborating with the writer, Bruce Smith, interviewing the now elderly friends and colleagues who helped her father establish medicare.

The role, a labour of love for the young actor, won’t likely be noticed in the U.S. or boost his career. But stepping away from Hollywood is nothing new for him. For two years in tbe early ’90s, he dropped out of show business to become a professional rodeo cowboy, even winning a team roping championship. In 1997, he appeared opposite his mother in “The Glass Menagerie” at Ottawa’s National Arts Centre, where he and his Douglas grandparents once watched her play the formidable Martha in “Who’s Afraid of Virginia Woolf?”

In spite of a grueling filming schedule for “24,” an excited Sutherland flew to Ottawa in October to join Douglas at Rideau  Hall. He watched proudly as Governor General Adrienne Clarkson made her an Officer in the Order of Canada, citing her work as a fine performer and her social activism on behalf of not-for-profit health care. Pleased as she was by the honour, Douglas was equally touched by her son’s desire to be there for the occasion.

Although he visits his mother and his twin sister, Rachel, in Toronto, he lives in California and understands the inequities of the American health-care system. (He broke fingers in his rodeo days, notes his mother.)

Next page: Don’t lose it

Ironically, when she was first invited to work with the Canadian Health Coalition, Douglas was surprised to find that support for Canada’s universally accessible health care was also coming from Americans. Dr. Arnold Relman, professor emeritus of medicine and of social medicine as well as editor-in-chief emeritus of the New England Journal of Medicine, says Canadians need to understand the consequences of an American-style market-oriented, fragmented health-insurance system, one that, he says, results in “uncontrollable costs, lack of access and inequality.” (As recently as August 2003, a study in the NEJM reported that in 1999, the cost of administering health care in the U.S. was $1,059 US per person versus $307 US in Canada.)

A familiar battle
Says former president of Toronto’s Ryerson University, Walter Pitman, “Because of her own stature and personality, Shirley Douglas has given a focus on the importance of health care that couldn’t be given by anyone else.” Moreover, he adds, she understands the health-care battle in the context of politics.

Douglas is deeply suspicious of the motives of both federal and provincial governments. Health care could not escape cutbacks as they struggled to control spending and pay down deficits over the last two decades. However, she warns, “We’re cutting in places that will undermine the system.” It’s a strategy she fears is aimed at allowing the privatization of Canada’s medical care. “You’ve got a totally unprogressive group of people who want to see health care back in the hands of insurance companies and health-care companies,” she says, the same interests that opposed her father in the 1940s and in the 1960 election. She points out the weakness of private medicine in simple terms: “If you have a million dollars to spend and you have to take a chunk out of it for the profit of the company, you have less to spend on patients.”

Fighting to keep something is often harder than fighting to get it, she says. “People have to realize that the health system can be gone – unnecessarily. They have to get on the phones and send faxes [to politicians]. But people think it will always be there. They’re just busy trying to survive and don’t pay enough attention until it’s too late.”

Adds Michael McBane of the Canadian Health Coalition, “As a young person, Shirley saw how nasty the fight was to get medicare in Saskatchewan. Her compelling message is ‘Wake up, folks. It’s not going to be nice if we lose this.'”