We might be led to believe that homecare was an oversight when Canada’s universal health insurance program (Medicare) was established in1966. Or that homecare was only peripheral to achieving the full intent of the new courageous national program designed to build a healthy and united Canada. But we’d be wrong; nothing could be further from the truth.
Canada’s seminal1964/65 Royal Commission on HEALTH SERVICES, in fact made eight recommendations on homecare. These recommendations, as listed below, are taken word for word from VOLUME 1 of the Royal Commission’s final report.
- 116-That every hospital in Canada of 100 beds or more introduce either independently, or in association with other hospitals in the same centre, other community organizations, the local health department, or any combination of these, a home care programme.
- 117-That local medical societies establish a liaison committee to expedite the development and use of home care
- 118-That hospital medical review committees stress the early discharge of patients who can be suitably cared for at home with the services of such a programme.
- 119-That pamphlets describing the programme and its services be prepared and distributed to patients considered possible candidates for early discharge under the programme.
- 120-That the Hospital Insurance and Diagnostic Services Act regulations be interpreted to cover costs of patient care provided by hospital-based home care programmes.
- 121-That the Hospital Insurance and Diagnostic Services Act regulations be interpreted to include as shareable costs payments made to community-based homecare programmes for care provided to hospital patients returned to their homes but retained on the hospital register.
- 122-That the Public Health Grant be used to assist in financing community-based home care programmes
- 123-That public health departments and voluntary agencies be encouraged by such grant assistance to undertake home care programmes either as community-based programmes or in co-operation with hospitals.
The new Medicare insurance program laid a foundation for covering our hospital expenses when we went to the hospital; and our medical expenses when we went to the doctor. For so many years these two pillars laid a foundation for advances in our evolving health system. But a federal/ provincial inability to re-negotiate a cost sharing agreement for “home care programmes” denied the laying of an essential third pillar to a modernized Medicare program.