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Crisis in Health Care
February 2001

Current Health Care CrisisA Canadian Perspective

Author Affiliations

From the Department of Surgery, Montreal General Hospital, Montreal, Quebec.

Arch Surg. 2001;136(2):169-171. doi:10.1001/archsurg.136.2.169

To comprehend the current loss of favor with Canada's most revered social program, it is useful to review its development and recent changes in funding and application. Canada's health care program has evolved over a span of more than 50 years. The current comprehensive national health insurance program began in the post–World War II era with a "land tax" program to subsidize hospital construction in rural Saskatchewan. This led to a general health grant program in 1948 primarily for hospital construction. A Canada-wide hospital insurance act followed in 1958, which provided coverage for hospital care and any diagnostic procedures conducted in a hospital. Several provinces in the early 1960s moved to a medical insurance plan for coverage of all physicians' fees. In 1965, special federal funds were segregated for the development of new and expansion of existing academic health centers with the goal of making Canada self-sufficient in terms of producing all health care professionals. By 1969 to 1970, all Canadian provinces had put in place a comprehensive, publicly financed health care system. This system was based on 5 basic fundamentals, which included:

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