36 Steps on the Road to Medicare by Houston C. Stuart;Massie Merle; & Merle Massie

Author:Houston, C. Stuart;Massie, Merle; & Merle Massie
Language: eng
Format: epub
Publisher: McGill-Queen's University Press
Published: 2013-10-31T00:00:00+00:00

CHAPTER 8

PROVINCEWIDE HOSPITALIZATION

Hospital services are costly. They require support from municipal and provincial governments to provide funding and sound policies. Above all, the primary concern should be for the patient. With momentum gained from experience with cottage and union hospitals and the Swift Current Health Region No. I, Saskatchewan moved toward provincewide hospitalization.

22. The first province to provide capital grants for widespread hospital construction, 1945

Saskatchewan took Sigerist’s advice to heart in becoming the first province to provide funds for capital construction of hospitals, a major step on the road to medicare.1 Between 16 March 1945 and 1 March 1949, the government provided $653,714 in outright construction grants and $173,500 in loans.2 The National Health Grants Programme in 1948 added substantial federal funds to support hospital construction; Saskatchewan, sadly, having been too quick off the mark, was ineligible for matching federal funds for new construction since most of its hospitals had already been built. The province was in double jeopardy because some of the operational health programs had also been launched in anticipation of federal support; it was learned only too late that, because they were already underway, they were disqualified from receiving federal assistance.3 Nonetheless, the Saskatchewan program moved hospital construction costs out of tight municipal budgets, allowing larger, better equipped hospitals to be built. Larger centralized hospitals could incorporate modern conveniences and technologies, from plumbing and heating infrastructure to power, which led to specialized laboratory and x-ray rooms. Twenty-one new hospitals were established over four years, and forty-one union hospital districts formed.4

23. The first universal hospitalization insurance program in North America, 1 January 1947

Introduction of the first provincewide, compulsory hospitalization insurance program in North America was achieved in Saskatchewan with remarkable speed and efficiency. Hospitalization was expected to cost even more than physician services and thus be the more expensive “half” of the medicare equation.

Sigerist estimated that universal, provincewide hospitalization insurance would cost $3.60 per person (about $3.5 million)5 per year and would require another 1,000 to 1,500 hospital beds in Saskatchewan,6 including a university hospital of at least 500 beds.7 The first steps toward provincewide hospitalization insurance included: the Saskatchewan Social Assistance Plan (1 January 1945; see chapter 5), which paid for both medical and hospital services for the province’s most needy; free hospitalization and treatment for cancer patients; and full coverage for hospitalization and treatment for mental illness.8 The move to provincewide hospitalization insurance would spread the cost of hospital care across all citizens and ease financial pressure on smaller municipalities. It would also be least likely to disrupt the balance between the doctors’ professional considerations and provincial or regional purse strings.9 The doctors in Saskatchewan enthusiastically and almost unanimously supported the introduction of provincewide hospitalization insurance on 1 January 1947. Doctors could now admit patients to hospital whenever necessary, without concern for cost. Patients could be treated in whichever hospital was best for their care, for the time needed to recover, whether that was a few days or many months. Small hospitals rejoiced, for a time.

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