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Brief
History of Medicare 1867 The
Constitution Act of 1867 (formerly known as the British North America
Act) defines health care as a family or local concern and makes the
provinces responsible for its maintenance. Quarantine, marine hospitals,
natives, and immigrants are the only aspects of health care handled by
the federal government. 1948 1957 The
Hospital Insurance and Diagnostic Services Act provides conditional
grants to the provinces from the federal government. Both governments
share in the cost of establishing a national hospital insurance plan.
The criteria for the plan are that it must be universally available,
portable, and administrated publicly 1964 Appointed
by Prime Minister John Diefenbaker, former Saskatchewan chief justice
Emmett Hall heads the Royal Commission on Health Services from 1961 to
1964. Hall affirms the criteria of the national health plan
(universality, portability, and public administration). He adds to its
mandate that health care must be accessible and comprehensive by
extending the health plan to health care beyond the hospitals. 1966 The
Medical Care Act is passed by the federal government. It extends
health-care coverage to include doctors' services outside hospitals. 1972 All
provinces universally participate in what we now call Canadian medicare.
1974 The
Minister of National Health and Welfare, Marc Lalonde, releases A New
Perspective on the Health of Canadians: A Working Document. It outlines
health-care strategies for a universal medical system. 1977 The
Federal-Provincial Fiscal Arrangements and Established Programs
Financing Act changes the cost-sharing model of financial support for
health care. The federal government offers block funding, which consists
of tax transfers and cash payments to the provinces based on the gross
domestic product (gdp). These payments are conditional on the provinces'
ability to meet certain criteria as outlined by the federal government. 1980 Former
chief justice Emmett Hall releases a report called Canada's
National-Provincial Health Program for the 1980s. The report suggests
that extra billing by doctors and user fees by hospitals will endanger
the principle of universality by denying reasonable access to health
care for all Canadians. 1981 The
House of Commons Task Force on Federal-Provincial Fiscal Arrangements
agrees with Hall's 1980 report, but also concludes that federal funding
for health care is inadequate. 1984 The
Canada Health Act consolidates previous federal legislation regarding
health care. It also reaffirms the criteria for the provinces to receive
federal funding for insured and extended health-care services. The five
criteria are as follows: comprehensiveness, public administration,
universality, portability, and accessibility. 1986 The
Minister of National Health and Welfare, Jake Epp, releases Achieving
Health for All: A framework for Health Promotion. It emphasizes that
income security, employment, education, housing, and agriculture all
have an impact on health-care policy. 1990 The
Senate Standing Committee on Health and Welfare, Social Affairs, Science
and Technology produces a report called Accessibility to Hospital
Services-Is There a Crisis? It looks at inefficiencies in acute-care
hospitals and concludes that these issues have been resolved through
innovative problem solving by hospital administrators. 1991 The
House of Commons Standing Committee on Health and Welfare, Social
Affairs, Seniors and Status of Women tables its report, The Health Care
System in Canada and Its Funding: No Easy Solutions. The report
concludes that problems in the existing health care sytem cannot be
resolved through increased spending. Therefore, more cost-effective
solutions need to be implemented at community and local levels. 1994 The
National Forum on Health is set up by the Minister of Health, Diane
Marleau. With a four-year mandate and a budget of $12 million, its 22
members will hold discussion groups and town hall meetings across Canada
to determine a new vision for Canada's health-care system. 1995 Finance
Minister Paul Martin announces a new federal formula for funding the
provinces called Canada Health and Social Transfer (CHST). Though not
official until April 1997, this block fund is worth $27 billion and
covers all annual support for health, education, and social services to
the provinces. All provinces must agree to a new unilateral funding
distribution, or the government will impose new arrangements on them. |