When was Medicare introduced in Canada?

Federal Medicare was introduced through the Medical Care Act of 1966 (14-15 Elizabeth II, c. 64), which received royal assent on December 21, 1966 and came into force on July 1, 1968. The Act provided 50-50 federal-provincial cost sharing for provincial public health insurance plans that met four conditions: comprehensive coverage of medically necessary physician services, universal coverage of provincial residents, public administration on a non-profit basis, and portability between provinces. All ten provinces had joined by 1972, building on Saskatchewan's pioneering 1962 provincial Medicare under Tommy Douglas.

Canadian public health insurance began with Tommy Douglas's CCF government in Saskatchewan. Saskatchewan introduced the first North American hospital insurance programme on January 1, 1947 (the Saskatchewan Hospital Services Plan). The federal Hospital Insurance and Diagnostic Services Act of 1957 (Louis St. Laurent's Liberal government) provided 50-50 federal-provincial cost sharing for provincial hospital insurance plans. By 1961 all provinces had joined the federal hospital insurance programme. Saskatchewan introduced the first comprehensive North American medical insurance (Medicare) on July 1, 1962, despite a 23-day Saskatchewan doctors' strike.

The federal Royal Commission on Health Services (the Hall Commission, named for Justice Emmett Hall) of 1961 to 1964 recommended a national Medicare programme on the Saskatchewan model. Lester B. Pearson's federal Liberal government introduced the Medical Care Act in July 1966, with the date of effect set for July 1, 1967 (later delayed by one year to July 1, 1968). The federal-provincial cost-sharing formula applied if the provincial plan met the four conditions; refusal to meet the conditions would result in loss of federal funding. The Act was passed against significant Conservative opposition.

Provincial adoption was sequential. Saskatchewan and British Columbia joined first (July 1, 1968), followed by Newfoundland (1969), Nova Scotia (1969), Manitoba (1969), Ontario (October 1, 1969), Alberta (July 1, 1969), Prince Edward Island (1970), Quebec (November 1, 1970, after a two-month doctors' strike), and finally New Brunswick (January 1, 1971). The federal Established Programs Financing Act of 1977 changed the funding structure from 50-50 cost-sharing to block transfers. The Canada Health Act of 1984 consolidated and updated federal Medicare principles, adding the principle of accessibility (no extra-billing or user fees in provincial insured services). The Canada Health Transfer (since 2004) is the principal federal funding mechanism. Canadian Medicare is one of the most popular features of Canadian government and a defining marker of Canadian identity, though its sustainability and modernisation have been continuing political issues.