How Canadian Workers Won Healthcare for All and How We Can Win It Here
August 20, 2025 by Summer Miller
Free public healthcare has never been handed down by the billionaires or their political servants. In every country where it exists, working people won it through mass struggle and militant labor action, with socialists leading the way.
In Canada, it took powerful workers’ movements, led by a growing working-class party, to force the government to implement their national public healthcare system in 1961.
Canada’s public healthcare victory came during a period of a far higher level international working-class struggle with mass socialist and working class parties in many countries. By the 1960s, mass movements erupted worldwide—from civil rights and anti-war protests in the U.S., to student and worker uprisings in France, to strikes and national liberation struggles across Asia, Africa, and Latin America.
Today in the U.S., the billionaires and both of their corporate parties, Democratic and Republican, have entrenched a for-profit healthcare system designed to line the pockets of insurance giants, big business, and the wealthy.
The private insurance industry rakes in record profits while millions of people are denied coverage, buried in medical debt, or grow sick and die from lack of access to care. Since Obama’s Affordable Care Act passed in 2010, the biggest insurers have raked in over $371 billion in profits. UnitedHealthcare alone pocketed $23 billion in profits last year — a 400% increase over the last decade — while denying nearly one in three claims.
Working people are rightfully enraged. Support for Medicare for All has surged to 70 percent. After UnitedHealth CEO Brian Thompson was killed last year, nearly 70 percent of Americans blamed the insurance industry’s greed and mass denials of care for his death.
Why were Canadian workers able to win their healthcare system, while the U.S.’s disastrous private, for-profit system has endured? What lessons does their struggle hold for our movement today?
International Class Struggle and the Seeds of Medicare In Canada
Before WWI, healthcare in Canada was fully for-profit—private doctors charged whatever they wanted, hospitals took only paying patients, and workers who couldn’t pay were often left to suffer or go into debt. Only a minority of workers had health insurance through employer-run plans. Working-class families did develop mutual aid societies to help each other pay for care, and some could fall back on charity care. But these stopgaps, while rooted in solidarity, were no match at all for the scale of working-class healthcare needed in Canada then, anymore than they are in the U.S. today for the millions of uninsured and underinsured.
The disastrous failures of the pre-war Canadian healthcare system helped lay the basis for mass struggles for public healthcare, but it took an all out-fight by Canadian workers to win. The struggle of Canadian workers was also a part of the wider international class struggle at that time. It was a period of revolution, titanic labor battles, and the growing organized power of workers around the world.
From the earth-shaking victory of the Russian Revolution in 1917 to workers’ parties taking power across Europe in the wake of WWII, the capitalist order was shaken. The Russian Revolution proved that the working class could seize power, socialize industry, and run society to meet the needs of ordinary people, rather than making profits for a ruthless capitalist class. Despite the counterrevolution that took place under Stalin, the unprecedented raised living standards and other gains from the Russian Revolution also stood as a beacon to millions of working people internationally, and set a counterexample that created pressure on the capitalists to make concessions to working class movements in their own countries.
Workers movements around the world followed aspects of the Russian example. They developed workers’ councils, occupied factories, and carried out militant strikes across Europe—from Germany’s 1918–1919 uprisings to Britain’s shop-stewards movement. Canada’s own 30,000-strong Winnipeg General Strike of 1919 was also inspired by the revolutionary events in 1917 Russia.
The USSR’s centrally planned healthcare system, with free clinics, hospitals, and advanced surgeries, demonstrated that a socialist system could deliver healthcare for all, despite the limits of that system under Stalinism.
The Great Depression, starting in 1929, further exposed the fundamental flaws of capitalism. Millions lost jobs and savings, and healthcare became further out of reach for large sections of the population. Mass strikes, factory sit-downs, and the growth of militant labor movements took place as the worst of the Depression started to subside and socialists led the way in crucial class battles.
Those movements forced concessions from bosses and governments, like unemployment insurance and public pensions—victories that laid the groundwork for fights for universal healthcare. The new workers’ parties that formed in many countries played a key role in helping to win major reforms, conceded by the capitalists out of the pressure from mass workers’ movements and the fear of revolution. In Canada, union membership nearly doubled between 1931 and 1945.
World War II further discredited the capitalist status quo. Workers who had sacrificed on the battlefield and in wartime industries returned to poverty wages and mounting medical bills. Across the world, mass workers’ parties took power: in France’s 1945 election, the Communist and Socialist parties together won 55 percent of the seats, and Britain’s Labour Party came to power in July of 1945. Workers parties played a key role in the fight to take healthcare out of corporate hands and make it a public good. The British Labour Party created the National Health Service in 1948.
Canadian socialists and union militants looked to the Russian Revolution and to postwar struggles in Europe as proof that healthcare could be organized around human need. Inspired by these examples, and radicalized by the failures of capitalism during the Depression, growing sections of the Canadian working class rejected the Liberal and Conservative parties and helped launch an independent, working-class party. Revolutionary forces played a key role in pushing the fight forward, helping to win public healthcare first in Saskatchewan—and later, Canada’s national Medicare system.
Political Independence and the First Breakthrough for Public Healthcare
In the U.S., the massive labor upsurge of the 1930’s led to the formation of the Congress of Industrial Unions and forced FDR to pass New Deal programs like Social Security, but it ultimately fell short of creating a new party for working people.
In contrast, Canadian workers and socialists made a decisive break instead and launched the Co-operative Commonwealth Federation (CCF)—an independent labor-farmer party formed in 1932 by unions, socialists, and farm organizations. Like in many European countries, the formation of an independent working-class party was crucial to pushing forward workers struggles in Canada and winning historic gains.
Public healthcare was a core demand of the CCF from the beginning.
In 1938, the CCF won just 18 percent of the vote in Saskatchewan. But by 1944, the experience of the Depression and war had radicalized large sections of the working class. Union membership surged, and strikes spread. The CCF, closely tied to labor, backed these fights. In that year’s election, the CCF won 53 percent of the vote and formed North America’s first social-democratic government under Tommy Douglas.
Saskatchewan—the province hit hardest by the Depression—became the CCF’s base. Its rural economy had collapsed under drought and falling wheat prices, resulting in mass unemployment. Immigrant farmers—many shaped by the traditions of European socialists—organized to survive. These weren’t wealthy landowners—they were working-class farmers crushed between tariffs and low crop prices. CCF organizers linked rural struggles to urban labor battles, often invoking the 1919 Winnipeg General Strike to tie healthcare demands to a broader tradition of working-class militancy.
How Saskatchewan Workers Won Hospital Insurance
Workers and farmers in Saskatchewan built a movement rooted in socialist ideas and the traditions of international class struggle to force the first real breakthrough toward a publicly funded healthcare system in North America.
With the CCF in office and a strong labor movement, Saskatchewan became the launching point for public healthcare. After 1944, industrial unions—especially in steel, mining, and the public sector—helped make healthcare a central, unifying postwar demand.
Between 1945 and 1947, Saskatchewan’s labor unions, farmers, and co-operative organizers launched a province-wide campaign to win public healthcare. Union locals held packed town halls and educational meetings in union halls, churches, and schools. United Farmers chapters distributed leaflets through co-op stores, grain elevators, and community fairs. The campaign faced a coordinated backlash from the College of Physicians and Surgeons, conservative politicians, and the right-wing press—who warned that public healthcare would mean “socialist tyranny” that would drive out doctors and bankrupt the province. But organizers fought back. They knocked doors in working-class neighborhoods, wrote letters to the editor, gave radio interviews, and packed community forums—exposing the lies and building mass support across the province.
Because working people had built their own political party—and organized through labor and co-ops—they had both the political vehicle and the power to fight. In 1947, the CCF government passed the Saskatchewan Hospital Services Plan, the first universal, tax-funded hospital insurance program in North America. By 1948, over 90 percent of the province was enrolled.
The victory in Saskatchewan set off a wave and inspired labor and farmer movements across the country to demand the same. United Farmers branches and provincial labor federations—soon unified under the Canadian Labour Congress (CLC), formed in 1956—held mass meetings, circulated educational materials, and built province-by-province campaigns. Under mounting pressure from labor, provincial movements, and the broader public, the federal government faced mounting pressure from labor, provincial movements, and the broader public and in 1957 passed the Hospital Insurance and Diagnostic Services Act in 1957, forced to pay half the cost of hospital care. By January 1961, every province had implemented public hospital insurance—driven by the same organized, independent working-class movement that first won it in Saskatchewan.
Saskatchewan As A Battering Ram for Universal National Healthcare
Winning hospital insurance was a major step forward—but it wasn’t enough. The plan only covered inpatient care. Doctor visits, diagnostics, and other essential medical services were still private and out of reach for sections of the rural poor and working class. Winning province-wide hospital care gave workers and farmers proof that public healthcare was possible. With hospital costs covered, the demand grew to cover doctor visits, diagnostics, and all medical care. The victory built confidence, momentum, and a broader base of support. It turned healthcare from a distant ideal into a winnable, next-step battle—and laid the groundwork for the fight for national Medicare.
In the late 1950s, pressure mounted on the CCF government to deliver on its long-standing pledge for full Medicare. The Saskatchewan Federation of Labour and its affiliated unions passed resolutions and organized support. The Saskatchewan Farmers’ Union held regional meetings and distributed bulletins calling for expanded public healthcare.
The capitalist opposition mobilized quickly. The Saskatchewan Medical Association, backed by the College of Physicians and Surgeons, private insurers, and business groups, launched a full-scale fear campaign. Conservative politicians and the right-wing press warned that public Medicare would bring “government interference,” mass doctor resignations, lower-quality care, and spiraling costs. When the Medical Care Insurance Act was set to take effect in July 1962, over 90% of doctors in the province walked out in a coordinated reactionary strike against Medicare aimed at collapsing the system before it could launch. While most strikes advance the interests of the whole working class if successful, this was an example of an entirely anti-worker strike aimed at holding back broader working class struggle for Medicare.
Workers had already fought for The Saskatchewan Federation of Labour and affiliated unions called emergency meetings and organized public rallies across the province. Co-operative networks printed and distributed thousands of leaflets to counter the misinformation. Women’s organizations—including church groups and rural homemakers’ clubs—mobilized to support families and keep daily life running. Volunteer-run clinics were set up, with help from pro-Medicare doctors from outside Saskatchewan, to ensure continued access to care. Union locals went door-to-door and held meetings in break rooms and community centers to explain what was at stake. This broad, disciplined response built public confidence, broke the doctors’ narrative against Medicare, and isolated the reactionary strike leadership.
It was not an accident that the capitalists whipped up fear among a part of a better-paid section of the middle class in order to carry out this attack. This is a tactic the capitalists have used through history and employ as part of their strategies of divide-and-rule.
It was crucial that workers and the CCF leaders held firm and fought back.
After 23 days, the doctors’ strike collapsed. Medicare went into effect in Saskatchewan—and it worked. Families no longer had to go into debt or delay treatment. Utilization surged, showing just how many had gone without care. The dire predictions never materialized. Care improved, doctors stayed, and Saskatchewan’s success galvanized working-class movements across the country.
That victory broke open the national fight. Under growing pressure, the federal government passed the Medical Care Act in 1966, offering to cost-share with any province that implemented Medicare. By 1972, every province had universal public health insurance for both hospital and physician care. Notably, today a large majority of doctors in Canada fully support the Medicare system.
Medicare was won the same way hospital insurance had been: through mass class struggle, led by organized workers and an independent party that could rally support across the country. It started in one prairie province, where union members, farmers, nurses, and organizers took on the capitalist establishment—and proved that free public healthcare for all isn’t a dream, it’s something we can fight for and win.
Mistakes of the CCF: Can we win free healthcare for all faster?
While the CCF helped unify rural and urban struggles and gave working people a political vehicle of their own, its leadership was shaped by a reformist outlook from the beginning—based on the idea that capitalism can be reformed and we don’t need a new kind of society altogether. This approach laid the foundation for the party’s gradual transformation into the pro-capitalist New Democratic Party. This reformist approach not only fails to recognize the need to fight for a socialist society, it also resulted in strategic mistakes, which overall acted to slow down struggles, including the struggle for Medicare. This is one reason for the 20-year gap between the first victory in Saskatchewan and the victory of full medical insurance programs in all provinces.
Even during World War II, the CCF called for “national unity” with the capitalist parties, supported wage controls, and opposed strike actions. Once in power, they backed away from earlier commitments to nationalize key industries—fearing confrontation with big business. The party’s founding program, the Regina Manifesto, had called for the eradication of capitalism, but under pressure, the CCF abandoned that goal in favor of a “mixed economy.” These concessions didn’t just weaken the fight for public healthcare—they showed that the party’s leadership wasn’t prepared to go beyond what the capitalist class would tolerate.
Premier Tommy Douglas—today widely celebrated—played an important role in the victory on Medicare, but he also publicly reassured the capitalists that the CCF would not interfere with private ownership of major industries. Even as working-class support for public ownership grew—fueled by demands to bring healthcare, energy, and other key sectors under democratic control, and inspired by international struggles like the Russian Revolution and postwar labor militancy—the CCF took a reformist and conciliatory approach to corporate power. Rather than building a revolutionary movement to seize power—they redirected working-class anger into elections and legislative reforms which confined it to what could be achieved without fundamentally challenging capitalist ownership. This approach laid the groundwork for the CCF’s eventual transformation into the New Democratic Party—a party fully committed to managing capitalism, not overturning it.
At the same time, the CCF leadership acted as political opportunists. Again and again, they chose class collaboration over class struggle. Revolutionary socialists were driven out of the party. Union militants who called for nationalization or pushed for strike action were sidelined and silenced. These weren’t tactical retreats—they were deliberate choices to keep the working class within the safe boundaries of what capitalism could tolerate.
What made the CCF’s victories possible—despite the failures of this leadership—was the fact that working people had built their own political party, independent of the capitalist class. That break, even under reformist leadership, gave workers and organizers the space to launch mass campaigns and build support around clear, class-based demands, putting pressure on the CCF leadership to go further than they otherwise would. It proved that without political independence, movements are left to beg and bargain with parties that exist to defend the capitalist system. But it also showed that independence alone isn’t enough. Without a revolutionary program and a leadership rooted in class struggle, every gain is partial—and every victory can be clawed back. For decades, the Canadian capitalist class has been working to claw back the historic victory on Medicare by underfunding it and fighting to privatize parts of it.
Douglas and the CCF were not revolutionary socialists, but having a workers’ party in power was a key element in winning healthcare and other reforms. The CCF government prioritized health and welfare in its early budgets—but it was the organizing and pressure of unions and working-class organizations that forced the fight forward. We urgently need a new party for working people in the United States. We also urgently need to develop revolutionary leadership that understands that true gains for workers can only come at the expense of the capitalists, meaning that to achieve everything workers need requires ultimately breaking with capitalism entirely. This kind of leadership can act as an accelerator for the struggle for free healthcare for all, rather than a barrier to overcome.
Lessons from Canada: We Can Win Free Public Healthcare In the U.S.
Lesson 1: Build a Fighting Workers’ Movement
Canada’s Medicare victory was won through class struggle. Industrial unions like the United Steelworkers and International Union of Mine, Mill and Smelter Workers didn’t just bargain for healthcare on the job—they fought for a universal, publicly-funded system for all working people.
When the capitalists mobilized reactionary doctors to go on strike in 1962 to try to kill Medicare, labor stepped up. Union members organized protests, defended clinics, and stood with working-class communities to break the strike. That kind of solidarity and class-struggle approach is what made victory possible.
In the U.S., we won’t win free healthcare for all without building a fighting workers’ movement. Workers can’t wait for permission from business unionist misleaders—we’ll need coordinated strike action to take on both billionaire-backed parties. To win free public healthcare in Seattle—and advance a national movement—rank-and-file union members will need to put massive pressure on conservative union leaders to organize strike action, escalate the fight, and push past any leaders who stand in the way. Unions need to force free healthcare for all to the center of the labor movement.
Working people need to go on the offensive through tactics like the Seattle ballot initiative for free healthcare for all by taxing the rich, as Workers Strike Back and Kshama Sawant are organizing.
Lesson 2: We Need a New Party for Working People—And Revolutionary Leadership
The CCF emerged out of the failure of Canada’s two main capitalist parties to solve the crises of the Depression—mass unemployment, rural collapse, and soaring inequality. It was built as an independent party of working people, rooted in labor battles, farmer struggles, and socialist leadership. It wasn’t tied to corporate donors or big business—and that made all the difference.
In the U.S., no such break was made. There was potential for a U.S. Labor Party in that same period but it was not realized due to misleadership by both labor leaders and the Stalinized Communist Party. Workers were instead pulled back into the Democratic Party —a party owned and controlled by the capitalist class — which has acted as a graveyard for movements, including in the fight for public healthcare.
To this day, no major gain for working people has ever been led by the Democratic establishment. And no movement tied to the corporate political system will fight to win public healthcare. Democrats have again and again pulled the plug on all efforts to win Medicare for All, including in states like California where they have huge majorities.
That’s why we need to build independent working-class organizations like Workers Strike Back—to win real victories like free public healthcare by taxing the rich in Seattle, to build the fight for free healthcare for all nationally, and to build the strongest independent, pro-worker, anti-genocide campaign to send Kshama Sawant to the U.S. Congress. Having an independent socialist fighter like Kshama in Congress can amplify our movements immensely, and would be an important step towards a new party for working people.
Lesson 3: We Need a Class-Struggle Strategy—Not Moral Appeals to the Capitalist Class
Canada didn’t win Medicare through polite debate or by begging billionaire-backed politicians to do the right thing. It was the product of decades of class struggle—mass strikes, socialist organizing, and growing international working-class power that forced concessions from the capitalist class.
We won’t win free healthcare for all in the U.S. by appealing to the conscience of politicians. And we won’t win by waiting on so-called progressive Democrats in Congress who have betrayed us again and again. We’ll win by building a mass working-class movement strong enough to make the billionaires and their political servants fear the cost of saying no.
Lesson 4: Local Victories Can Build to National Victories
Saskatchewan showed what’s possible when the working class is organized and ready to fight. Backed by labor and mass action, workers defeated big business and the political establishment—and won free public healthcare. That victory spread. By 1961, every province had hospital insurance. In 1966, the federal government was forced to expand Medicare nationwide—not out of goodwill, but because working class movements and a workers party had already made it real on the ground.
We’ve seen the same dynamic in the U.S. When Kshama Sawant’s City Council office, workers, and other socialists won the country’s first $15/hour minimum wage in 2014 through the independent, working-class 15 Now movement, it lit a fire. Workers in other cities launched their own movements for $15 and fought to win it themselves, and the minimum wage went up in many other cities across the country.
We can do the same with the fight for free healthcare for all by taxing the rich. A breakthrough in one city—like winning it in Seattle—can be a battering ram to crack open a national fight. But like in Saskatchewan, it won’t spread without militant workers’ action and a fighting, organized movement.
Lesson 5: We Have to Be Ready to Defend Our Victories
Canada’s Medicare for All system remains hugely popular—because it works. People live longer, aren’t crushed by medical bills, and care is free at the point of use. It costs far less than the U.S. system and has far better health outcomes. None of this pleases the capitalists, and they and their political parties are working to dismantle Canada’s healthcare system. Private clinics are spreading, services are being outsourced, and for-profit care is expanding through legal loopholes. Both big business parties refuse to enforce the Canada Health Act.
We cannot forget that the capitalist class will come after every victory we win. Insurance giants, big business, and capitalist parties will fight to block our campaign for free public healthcare—and if we win, to try to weaken that victory, and ultimately, to claw it back. We need mass movements of workers, union and non-union, led by socialists—ready to defend our every victory and to go on the offensive.
Lesson 6: The Fight for Free Public Healthcare Is International
Canada’s Medicare victory was part of a broader wave of international working-class struggle. It came during a period when workers, inspired by revolutions and mass strikes around the world, were forcing real concessions from the capitalist class.
The lessons of the Russian Revolution, the rise of mass workers’ parties in Europe, and the explosive growth of the U.S. labor movement helped arm a generation of working-class fighters with bold demands and a socialist vision. Capitalist governments, including Canada’s, made concessions like public healthcare not out of goodwill but in order to try to contain increasingly powerful working-class movements.
To win free healthcare for all in the U.S., we have to link our fight to the global struggle against capitalism. The same corporations denying care here are driving austerity abroad. Only a movement rooted in international working-class solidarity can break the grip of the capitalists to guarantee healthcare as a right and win a socialist world.