Canada's Health Care System
Timeline
1867
British North American Act passed: federal government responsible for marine hospitals and quarantine; provincial/territorial governments responsible for hospitals, asylums, charities and charitable institutions.
1897 to 1919
Federal Department of Agriculture handles federal health responsibilities until Sept. 1, 1919, when first federal Department of Health created.
1920s
Municipal hospital plans established in Manitoba, Saskatchewan and Alberta.
1921
Royal Commission on Health Insurance, British Columbia.
1936
British Columbia and Alberta pass health insurance legislation, but without an operating program.
1940
Federal Dominion Council of Health created.
1942
Federal Interdepartmental Advisory Committee on Health Insurance created.
1947
Saskatchewan initiates provincial universal public hospital insurance plan, January 1.
1948
National Health Grants Program, federal; provides grants to provinces and territories to support health-related initiatives, including hospital construction, public health, professional training, provincial surveys and public health research.
1949
British Columbia creates limited provincial hospital insurance plan.
Newfoundland joins Canada, has a cottage hospital insurance plan.
1950
Alberta creates limited provincial hospital insurance plan, July 1.
1957
Hospital Insurance and Diagnostic Services Act, federal, proclaimed (Royal Assent) May 1; provides 50/50 cost sharing for provincial and territorial hospital insurance plans, in force July 1, 1958.
1958
Manitoba, Newfoundland, Alberta and British Columbia create hospital insurance  plans with federal cost sharing, July 1.
Saskatchewan hospital insurance plan brought in under federal cost sharing, July 1.
1959
Ontario, New Brunswick and Nova Scotia create hospital insurance plans with federal cost sharing, January 1.
Prince Edward Island creates hospital insurance plan with federal cost sharing, October 1.
1960
Northwest Territories creates hospital insurance plan with federal cost sharing, April 1.
Yukon creates hospital insurance plan with federal cost sharing, July 1.
1961
Québec creates hospital insurance plan with federal cost sharing, January 1.
Federal government creates Royal Commission on Health Services to study need for health insurance and health services; appoint Emmet M. Hall as Chair.
1962
Saskatchewan creates medical insurance plan for physicians' services, July 1; doctors in province strike for 23 days.
1964
Royal Commission on Health Services, federal, reports; recommends national health care program.
1965
British Columbia creates provincial medical plan.
1966
Canada Assistance Plan (CAP), federal, introduced; provides cost-sharing for social services, including health care not covered under hospital plans, for those in need, Royal Assent July, effective April 1.
Medical Care Act, federal, proclaimed (Royal Assent), December 19; provides 50/50 cost sharing for provincial/territorial medical insurance plans, in force July 1, 1968.
1968
Saskatchewan and British Columbia create medical insurance plans with federal cost sharing, July 1.
1969
Newfoundland, Nova Scotia and Manitoba create medical insurance plans with federal cost sharing, April 1.
Alberta creates medical insurance plan with federal cost sharing, July 1.
Ontario creates medical insurance plan with federal cost sharing, October 1.
1970
Québec creates medical insurance plan with federal cost sharing, November 1.
Prince Edward Island creates medical insurance plan with federal cost sharing, December 1.
1971
New Brunswick creates medical insurance plan with federal cost sharing, January 1.
Northwest Territories creates medical insurance plan with federal cost sharing, April 1.
1972
Yukon creates medical insurance plans with federal cost sharing, April 1.
1977
Federal-Provincial Fiscal Arrangements and Established Programs Financing Act (EPF) federal cost-sharing shifts to block funding.
1979
Federal government creates Health Services Review; Emmet M. Hall appointed Special Commissioner to re-evaluate publicly funded health care system.
1980
Health Services Review report released August 29; recommends ending user fees, extra billing, setting national standards.
1981
Provincial/territorial reciprocal billing agreement for in-patient hospital services provided out-of-province/territory.
1982
Federal EPF amended; revenue guarantee removed, funding formula amended.
1983
Royal Commission on Hospital and Nursing Home Costs, Newfoundland, begins April, reports February 1984.
Comite d'étude sur la promotion de la santé, Quebec, begins, ends 1984.
La Commission d'énquête sur les services de santé et les services sociaux, Quebec, begins January, reports December 1987.
Federal Task Force on the Allocation of Health Care Resources begins June, reports 1984.
1984
The Canada Health Act, federal, passes (Royal Assent April 17), combines hospital and medical acts; sets conditions and criteria on portability, accessibility, universality, comprehensiveness, public administration; bans user fees and extra billing.
Provincial/territorial reciprocal billing agreement for out-patient hospital services provided out-of province/ territory.
1985
Health Services Review Committee, Manitoba, begins, reports November.
1986
Federal transfer payments rate of growth reduced.
Health Review Panel, Ontario, begins November, reports June 1987.
1987
Premier's Council on Health Strategy, Ontario, begins, ends in 1991.
Royal Commission on Health Care, Nova Scotia, begins August 25, reports December 1989.
Advisory Committee on the Utilization of Medical Services, Alberta, begins September, reports September 1989.
All provinces and territories in compliance with the Canada Health Act by April 1.
1988
Provincial/territorial governments (except Québec) sign reciprocal billing agreement for physicians' services provided out-of-province/territory.
Commission on Directions in Health Care, Saskatchewan, begins July 1, reports March 1990.
Premier's Commission on Future Health Care for Albertans, Alberta, begins December, reports December 1989.
Commission on Selected Health Care Programs, New Brunswick, begins November, reports June 1989.
1989 to 1994
Further reductions in federal transfer payments.
1990
Royal Commission on Health Care and Costs, British Columbia, begins, reports 1991.
1991
National Task Force on Health Information, federal, reports; leads to creation of Canadian Institute of Health Information.
Task Force on Health, Prince Edward Island, begins June, reports March 1992.
1994
National Forum on Health, federal, created to discuss health care with Canadians and recommend reforms, begins October, reports 1997.
1995
Federal EPF and CAP merged into block funding under the Canada Health and Social Transfer (CHST), to support health care, post-secondary education and social services.
1996
Federal CHST transfers begin April 1.
1998
Health Services Review, New Brunswick, begins, reports February 1999.
1999
Social Union Framework Agreement (SUFA) in force; federal, provincial and territorial governments (except Québec) agree to collective approach to social policy and program development, including health.
Minister's Forum on Health and Social Services, Northwest Territories, begins July, reports January 2000.
2000
First ministers' Communiqué on Health, announced September 11.
Commission of Study on Health and Social Services (Clair Commission), Québec, created June 15, reports December 18.
Saskatchewan Commission on Medicare (Fyke Commission), Saskatchewan, begins June 14, reports April 11, 2001.
Premier's Advisory Council on Health for Alberta (Mazankowski Council), Alberta, established January 31, reports January 8, 2002.
Premier's Health Quality Council, New Brunswick, begins January, reports January 22, 2002.
2001
Standing Senate Committee on Social Affairs, Science and Technology review (Kirby Committee), federal, begins March 1, publishes recommendations October 2002.
Commission on the Future of Health Care in Canada (Romanow Commission), federal, begins April 4, reports November 2002.
British Columbia Select Standing Committee on Health (Roddick Committee), begins August, reports December 10.
Northwest Territories Action Plan, begins November, reports January 2002.
[Health] Consultation Process, Ontario, begins July, results released January 21, 2002.
Health Choices - A Public Discussion on the Future of Manitoba's Public Health Care Services, Manitoba, begins January, reports December.
2003
First ministers' Accord on Health Care Renewal, announced February 5.
Health Council of Canada established to monitor and report on progress of Accord reforms, December 9.
2004
Federal CHST split into two transfers: the Canada Health Transfer (CHT) and the Canada Social Transfer (CST), April 1.
First ministers' A 10-Year Plan to Strengthen Health Care, September 16.
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