While we may not remember it, there was a time before Medicare in Canada.
Most Canadians living today were born after 1966, the year Canada’s universal health insurance program (Medicare) was established. And the rest of us might occasionally experience a touch of memory loss as we too often take Medicare for granted. But before Medicare, Canadians covered their healthcare costs by privately paying their hospital and doctors’ bills, or by purchasing private insurance, or by foregoing care, or by being classified as “indigent”. For example, when Stratford’s original public hospital, Stratford General Hospital Trust was built in 1891, many of the patients were, as with most hospitals in Canada, considered indigent. In some respects Stratford General Hospital was as much a poorhouse as it was a hospital. (Please see Dean Robinson’s book, entitled For Your Health, Stratford General Hospital 1891-2002, available in the Stratford Public Library). Communicable diseases, infections, endemics and epidemics often characterized the need for isolating patients in separate community facilities. In 1891 the average lifespan of Canadians was 45 years.
As the 20th century proceeded medical discoveries, previously unimaginable, were gradually introduced into Canadian healthcare. Hospitals growing inpatient and outpatient services resulted in pressure on governments to legislate “insurance” programs that would serve returning World War II veterans, burgeoning industry workers, increasing numbers of newborns and growing families. As Statistics Canada notes, “Nearly half of all the gains in life expectancy occurred in the period between 1921 and 1951, largely due to reduced infant mortality.” By the time the “new” Stratford General hospital was built in 1951 lifespans had reached 67 years. After WWII three western provinces introduced hospital insurance programs in the 1940s. These new insurance programs covered the costs of x-rays, and laboratory tests, emergency visits, some rehabilitation service and a per diem bed charge. In1959 Ontario followed with its own Ontario Hospital Insurance Plan.
Provincial medical insurance laws followed hospital insurance laws. Ontario came on board with its 1966 Ontario Medical Services Insurance Plan, which morphed into the Ontario Health Services Insurance Plan (soon shortened to simply OHIP). In the meantime, the seminal 1964/65 Royal Commission on Health Services had convinced Canada’s federal and provincial governments of the need for a nation-wide publicly funded “universal” hospital and medical insurance program. Insured hospital and doctor services became the two pillars of our “Medicare” program in 1966. We should not forget that sacrifices, untold struggles and drawn-out legislative battles by those who went before us lay within our history of Canadian Medicare.