420:, health care in Canada was privately funded and delivered, with the exception of services provided to the sick poor that were financed by local governments. The experience of the 1930s left many Canadians in challenging financial situations. As personal financial situations deteriorated, the municipal governments were overwhelmed. Though the provinces provided relief payments for food, clothing, and shelter, additional medical costs were beyond the capacity of most of the provincial budgets. Many Canadians were not receiving adequate medical care, and those that did were overwhelmed with the associated costs. As such, preventable diseases and deaths were still common occurrences.
154:
324:
578:
435:
33:
493:
diagnostic services. Formally, federal funding comprised 25% of the per capita costs for hospital services in Canada plus 25% of the per capita costs for hospital services in the province or territory multiplied by the number of insured persons in that jurisdiction. Funding was made available to any province or territory that agreed to make insured hospital services available to the region under uniform provisions.
427:, followed by six years of war, formed the social context of the ambitious federal Green Book proposals. In a bid for unprecedented cooperation between the federal and provincial governments, these initiatives formed the foundations of a national program for social security, including provisions for health insurance. However, the failure to come to a consensus on the required allocation of tax resources at the
519:
for services from patients, such charges would have reduced the federal contribution since, under the cost-sharing arrangement, federal funding was proportional to provincial and territorial contributions. Therefore, the Act intrinsically deterred provinces and territories from charging patients for services.
471:
After several years of debate between the stakeholders, including
Canadian medical professional associations and the provincial governments, the federal government made an offer to fund approximately one half of the national cost of diagnostic services and in-patient hospital care for provinces that
518:
Provinces and
Territories were also obligated to limit co-payments and other "deterrent" fees to ensure that patients were not placed under financial burden at the point of care. Though there was no other explicit provision preventing provinces and territories from demanding financial contribution
467:
insurance system. The success of these provincial plans combined with the volume of illness and associated costs, in addition to provincial disparities in health coverage, fuelled debate on the topic of a federally funded health service. There was much disagreement as to the appropriate scope,
387:
in 1957 that reimbursed one-half of provincial and territorial costs for hospital and diagnostic services administered under provincial and territorial health insurance programs. Originally implemented on July 1, 1958, with five participating provinces, by
January 1, 1961, all ten provinces were
585:
The HIDS Act laid the foundation for other notable developments in the
Canadian health care system. One of the criticisms of the Act was that it did not cover medical services, which in 1955 comprised approximately 40% of national healthcare costs. Following the adoption of the HIDS Act, then,
446:
proceeded with a plan for provincial hospital insurance. From the collective efforts of the "wheat economy" came a cooperative movement towards efficient agencies to deliver services to
Saskatchewan’s sparse population. Strong local engagement contributed to the creation of the union hospital
616:
was passed in 1977, transferring the responsibility of the program to the provinces by decoupling the amount of the federal transfer from the provisions. Some provinces levied user charges and authorized extra-billing, which threatened universal and free access to healthcare. In response, the
492:
On May 1, 1957, the HIDS Act was formally legislated in Canada in response to the increasing pressures for national comprehensive health insurance. Under the Act, the federal government agreed to fund approximately 50% of the costs of provincial or territorial insurance plans for hospital and
609:
brought hospital and physician services to all
Canadians, regardless of their ability to pay. Though criticized for imposing federal priorities on provincial jurisdiction, provincial governments were left with no option other than to meet the federal provisions or forgo supplementary funding
573:
By 1961, almost all
Canadians were entitled to comprehensive hospital care benefits, protecting them from large hospital bills. The HIDS act enabled hospital operations that were not previously feasible and facilitated access to care for who could not otherwise afford it.
462:
Saskatchewan's decision to launch the
Saskatchewan Hospital Services Plan accelerated and influenced the development of other provincial insurance plans. The British Columbia Hospital Insurance Service was passed in early 1948 and followed soon after by the
527:
Provincial and territorial insurance plans were to cover acute, convalescent, and chronic care of patients, including diagnostic services and in-patient drug administration in hospital facilities. However, coverage was not provided for hospitals for
447:
system and municipal hospital care plans. However, a solution to the problem of providing medical and hospital services to a population reeling from the devastating effects of the depression required a greater provincial contribution. The
548:
Each province and territory was to be responsible for administering its own plan; therefore, each had the right to decide how to raise its proportion of funding for the insurance program, either through insurance premiums or taxation.
674:
557:
Under the Act, insured services could only be delivered by hospitals, most of which were private entities. Hospital employees including physicians, laboratory technicians, and radiologists were to be paid via a
388:
enlisted. The federal funding was coupled with terms and conditions borrowed from the
Saskatchewan Hospital Services Plan, introduced in 1947 as the first universal hospital insurance program in
431:
in August 1945 precluded adoption and delayed subsequent action. Although the Green Book proposals were not adopted, they effectively created an appetite for government-funded health services.
236:
565:
The passage of the HIDS Act was the first milestone in the evolution of national health insurance in Canada and provided the foundation for all future
Canadian Health legislation.
60:
An Act that reimbursed one-half of provincial and territorial costs for hospital and diagnostic services administered under provincial and territorial health insurance programs
505:
Comprehensiveness: All-encompassing in-patient and out-patient hospital services as well as diagnostic services were to be made available under the insurance plan.
511:
Accessibility: Services were to be made reasonably accessible to insured persons in a manner that did not preclude or impede access either directly or indirectly.
352:
638:
514:
Portability: Provincial plans were to provide coverage for out-of-province Canadian residents who were insured by home provincial or territorial plans.
451:
won their first majority government in 1944. Continuing the Liberal health insurance platform that introduced "A Bill Respecting Health Insurance,"
392:. In order to receive funding, services had to be universal, comprehensive, accessible and portable. This stipulation was dropped in 1977 with the
345:
828:
338:
448:
198:
621:
in 1984 to re-instate the principles of the HIDS Act and also the Medical Care Act. Those Acts were then repealed.
786:
833:
656:
612:
587:
428:
394:
838:
823:
818:
727:
283:
214:
137:
459:
as well. By 1947, Saskatchewan introduced the first universal hospital insurance program in North America.
455:, as the new premier, signalled his commitment to the provision of health services by assuming the role of
456:
192:
170:
586:
extending health insurance to cover additional medical services was next on the federal agenda. At the
501:
Participating provinces and territories were obligated to satisfy four funding conditions as follows:
843:
481:
799:
508:
Universality: Services were to be made available to all residents of the province or territory.
187:
770:
The determinants of hospital utilization under a universal public insurance program in Canada
405:
273:
408:, the HIDS Act was a landmark example of federal-provincial cooperation in post-war Canada.
533:
384:
278:
221:
153:
145:
72:
40:
8:
746:
The Hospital Insurance and Diagnostic Services Act: Its impact on hospital administration
100:
745:
434:
288:
268:
231:
618:
595:
591:
484:, accepted the proposal, laying the groundwork for a Canadian health insurance plan.
400:
310:
305:
298:
226:
182:
176:
473:
424:
577:
559:
372:
293:
241:
114:
769:
812:
713:
452:
389:
328:
163:
537:
529:
443:
417:
562:
model negotiated with the provincial or territorial administrative body.
404:. Widely acknowledged as the foundation for future developments in the
51:
32:
477:
464:
380:
377:
Loi sur l’assurance-hospitalisation et les services diagnostiques
768:
Manga, Pran, Broyles Robert W., & Angus, Douglas E. (1987).
728:
Making Medicare: The history of health care in Canada, 1914–2007
125:
594:
was made. Then, on July 1, 1967, the governing Liberals under
602:, covering 50% of physician costs outside of a hospital.
468:
funding allocation, and administration of such a plan.
472:
implemented insurance plans. Five provinces, namely
16:
Repealed Canadian legislation for health care funding
442:Despite a lack of commitment for federal funding,
669:
667:
665:
540:, capital expenditures, or administrative costs.
810:
438:Cooperative Commonwealth Federation Party banner
662:
368:Hospital Insurance and Diagnostic Services Act
25:Hospital Insurance and Diagnostic Services Act
346:
717:, McGill-Queen's University Press, Montreal.
649:
610:altogether. To address these concerns, the
800:The Canada Health Act: Overview and options
720:
714:Health Insurance and Canadian Public Policy
787:The health of Canadians – The federal role
353:
339:
31:
779:
707:
705:
703:
675:Royal Commission on Health Services fonds
639:"Le système des soins de santé du Canada"
117:, Minister of National Health and Welfare
740:
738:
736:
726:Canadian Museum of Civilization (2010).
701:
699:
697:
695:
693:
691:
689:
687:
685:
683:
576:
433:
764:
762:
760:
758:
811:
792:
733:
680:
755:
750:Canadian Medical Association Journal
449:Co-operative Commonwealth Federation
398:and then reinstated in 1984 in the
13:
613:Established Programs Financing Act
395:Established Programs Financing Act
14:
855:
617:federal government enacted the
590:in July, 1965, the decision for
322:
152:
631:
429:Dominion-Provincial Conference
1:
789:. Retrieved December 7, 2012.
624:
588:Federal-Provincial Conference
496:
411:
829:Canadian federal legislation
645:. Santé Canada. 27 May 2011.
7:
744:Turner, J. Gilbert (1958).
711:Taylor, Malcolm G. (1978).
657:Canada's Health Care System
605:Together, the HIDS Act and
568:
552:
522:
487:
406:Canadian health care system
10:
860:
543:
476:, Alberta, Saskatchewan,
121:
110:
99:
94:
86:
78:
68:
46:
39:
30:
23:
250:Diagnostic Services Act
798:Madore, Odette (2005).
785:Parliament of Canada.
655:Health Canada (2012).
582:
439:
376:
248:Hospital Insurance and
237:Comparison with the US
834:Universal health care
580:
437:
839:1957 in Canadian law
824:Health law in Canada
819:Healthcare in Canada
385:Parliament of Canada
199:Controlled Drugs and
193:Non-Insured Benefits
146:Healthcare in Canada
73:Parliament of Canada
41:Parliament of Canada
215:History of medicine
95:Legislative history
752:, 78(10), 768-770.
583:
440:
232:Father of medicare
171:Minister of Health
776:, 25(7), 658-670.
673:Archives Canada.
619:Canada Health Act
596:Lester B. Pearson
581:Lester B. Pearson
401:Canada Health Act
363:
362:
329:Canada portal
177:Canada Health Act
131:
130:
851:
844:Health insurance
803:
796:
790:
783:
777:
766:
753:
742:
731:
724:
718:
709:
678:
671:
660:
653:
647:
646:
635:
607:Medical Care Act
600:Medical Care Act
534:mental hospitals
474:British Columbia
355:
348:
341:
327:
326:
325:
242:Indian hospitals
156:
133:
132:
79:Assented to
35:
21:
20:
859:
858:
854:
853:
852:
850:
849:
848:
809:
808:
807:
806:
797:
793:
784:
780:
767:
756:
743:
734:
725:
721:
710:
681:
672:
663:
654:
650:
637:
636:
632:
627:
598:introduced the
571:
560:fee-for-service
555:
546:
525:
499:
490:
457:Health Minister
414:
359:
323:
321:
316:
315:
264:
256:
255:
249:
217:
207:
206:
200:
188:Health Transfer
166:
115:Paul Martin Sr.
69:Enacted by
64:
61:
56:
55:
17:
12:
11:
5:
857:
847:
846:
841:
836:
831:
826:
821:
805:
804:
791:
778:
754:
732:
719:
679:
661:
648:
629:
628:
626:
623:
570:
567:
554:
551:
545:
542:
524:
521:
516:
515:
512:
509:
506:
498:
495:
489:
486:
413:
410:
383:passed by the
361:
360:
358:
357:
350:
343:
335:
332:
331:
318:
317:
314:
313:
308:
303:
302:
301:
291:
286:
281:
276:
271:
265:
262:
261:
258:
257:
254:
253:
244:
239:
234:
229:
224:
218:
213:
212:
209:
208:
205:
204:
201:Substances Act
195:
190:
185:
180:
173:
167:
162:
161:
158:
157:
149:
148:
142:
141:
129:
128:
119:
118:
112:
108:
107:
104:
97:
96:
92:
91:
88:
84:
83:
80:
76:
75:
70:
66:
65:
63:
62:
59:
49:
48:
47:
44:
43:
37:
36:
28:
27:
15:
9:
6:
4:
3:
2:
856:
845:
842:
840:
837:
835:
832:
830:
827:
825:
822:
820:
817:
816:
814:
801:
795:
788:
782:
775:
771:
765:
763:
761:
759:
751:
747:
741:
739:
737:
729:
723:
716:
715:
708:
706:
704:
702:
700:
698:
696:
694:
692:
690:
688:
686:
684:
676:
670:
668:
666:
658:
652:
644:
643:www.canada.ca
640:
634:
630:
622:
620:
615:
614:
608:
603:
601:
597:
593:
589:
579:
575:
566:
563:
561:
550:
541:
539:
538:nursing homes
535:
531:
520:
513:
510:
507:
504:
503:
502:
494:
485:
483:
479:
475:
469:
466:
460:
458:
454:
453:Tommy Douglas
450:
445:
436:
432:
430:
426:
423:Ten years of
421:
419:
409:
407:
403:
402:
397:
396:
391:
390:North America
386:
382:
379:, HIDS) is a
378:
374:
370:
369:
356:
351:
349:
344:
342:
337:
336:
334:
333:
330:
320:
319:
312:
309:
307:
304:
300:
297:
296:
295:
292:
290:
287:
285:
282:
280:
277:
275:
272:
270:
267:
266:
260:
259:
252:
251:
245:
243:
240:
238:
235:
233:
230:
228:
225:
223:
220:
219:
216:
211:
210:
203:
202:
196:
194:
191:
189:
186:
184:
181:
179:
178:
174:
172:
169:
168:
165:
164:Health Canada
160:
159:
155:
151:
150:
147:
144:
143:
139:
135:
134:
127:
124:
120:
116:
113:
111:Introduced by
109:
105:
102:
98:
93:
89:
85:
81:
77:
74:
71:
67:
58:
57:
54:
53:
45:
42:
38:
34:
29:
26:
22:
19:
794:
781:
774:Medical Care
773:
749:
722:
712:
651:
642:
633:
611:
606:
604:
599:
584:
572:
564:
556:
547:
530:tuberculosis
526:
517:
500:
491:
482:Newfoundland
470:
461:
444:Saskatchewan
441:
422:
418:World War II
415:
399:
393:
367:
366:
364:
247:
246:
197:
175:
122:
90:July 1, 1958
50:
24:
18:
274:Drug policy
82:May 1, 1957
813:Categories
625:References
497:Provisions
425:depression
412:Background
279:Euthanasia
222:Physicians
52:Long title
416:Prior to
87:Commenced
592:Medicare
569:Outcomes
553:Delivery
523:Coverage
488:Overview
289:HIV/AIDS
284:Refugees
269:Abortion
183:Medicare
138:a series
136:Part of
126:Repealed
106:Bill 320
544:Funding
478:Ontario
465:Alberta
381:statute
311:Obesity
306:Smoking
299:Suicide
227:Nursing
123:Status:
480:, and
373:French
294:Murder
263:Topics
103:title
365:The
101:Bill
772:,
748:,
815::
757:^
735:^
682:^
664:^
641:.
536:,
532:,
375::
140:on
802:.
730:.
677:.
659:.
371:(
354:e
347:t
340:v
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
