Failure in Canada’s medical system

I am writing regarding the editorial “Divided we stand, divided we fall,” (BCMJ 2007;49[3]:105). With the introduction of universal medical care Tommy Douglas never suggested the government should have a monopoly and be the only medical care provider. The Canada Health Act, introduced by the then–Health Minister Monique Begin, as her departing shot, has been a disaster for Canada’s medical health system. The Liberals at the time had guarantees from both opposition parties, the Conservatives and the New Democrats, that they would not embarrass the government if they let the Canada Health Act die on the floor. Unfortunately Monique Begin’s enthusiasm won the day, making private insurance for medical and hospital care illegal across the country. The elimination of the three words is crucial—effective, efficient, and responsible. 

Most large companies provide medical/dental insurance for their employees. If allowed, they would provide physician and hospital care at a reasonable premium, yet it is illegal. If individuals with private insurance were allowed to pay for their own care and leave the government to provide medical care for those without such coverage or those unable to pay, as they do with social services, adequate funding of the medical care system would be a non-issue. 

For those services in which the government has a monopoly, the record is dismal. When will Canadians force the politicians to back away from their medical care monopoly and put their efforts and focus where it belongs? Let Canada go back to having one of the better medical health care systems in the world as was true some 20 or 30 years ago. It certainly isn’t today as pointed out in BD’s editorial. 

—William W. Arkinstall, MD

William W. Arkinstall, MD. Failure in Canada’s medical system. BCMJ, Vol. 49, No. 6, July, August, 2007, Page(s) 297 - Letters.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

BCMJ Guidelines for Authors

Leave a Reply