Understanding Hospital Insurance And Diagnostic Services Act

The Hospital Insurance and Diagnostic Services Act (HIDS) is a statute passed by the Parliament of Canada in 1957 that reimbursed half of the provincial and territorial costs for hospital and diagnostic services. The Act was implemented on July 1, 1958, with five participating provinces, and by January 1, 1961, all ten provinces were enlisted. HIDS was a response to the increasing pressures for national comprehensive health insurance and was the first stage of Canada's national health insurance program, also known as Medicare.

Funding and cost-sharing

The Hospital Insurance and Diagnostic Services Act (HIDS) was passed by the Parliament of Canada in 1957. The Act, which came into force on July 1, 1958, with five participating provinces, aimed to reimburse one-half of provincial and territorial costs for hospital and diagnostic services under provincial and territorial health insurance programs. By January 1, 1961, all ten provinces had joined the program.

The federal funding was based on the Saskatchewan Hospital Services Plan, which was introduced in 1947 as the first universal hospital insurance program in North America. To receive funding, services had to be universal, comprehensive, accessible, and portable. This stipulation was removed in 1977 with the Established Programs Financing Act but was reinstated in 1984 in the Canada Health Act.

Under the Hospital Insurance and Diagnostic Services Act, the federal government agreed to fund approximately 50% of the costs of provincial or territorial insurance plans for hospital and diagnostic services. This included 25% of the per capita costs for hospital services in Canada, plus an additional 25% of the per capita costs for hospital services in the respective province or territory.

Each province and territory was responsible for administering its own plan and deciding how to raise its proportion of funding for the insurance program, either through insurance premiums or taxation. The Act intrinsically deterred provinces and territories from charging patients for services. Instead, provincial and territorial insurance plans were to cover acute, convalescent, and chronic care, including diagnostic services and in-patient drug administration in hospital facilities. However, it is important to note that this coverage did not extend to hospitals for tuberculosis, mental hospitals, nursing homes, capital expenditures, or administrative costs.

To ensure accessibility, the Act stipulated that provincial plans should provide coverage for out-of-province Canadian residents insured by their home provincial or territorial plans. Additionally, provinces and territories were obligated to limit co-payments and other "deterrent" fees to prevent patients from facing financial burdens at the point of care. While there was no explicit provision preventing provinces and territories from seeking financial contributions from patients, such charges would have reduced the federal contribution under the cost-sharing arrangement.

In 1977, the federal government altered the funding arrangement by passing the Federal-Provincial Fiscal Arrangements and Established Programs Financing Act. Instead of a 50-50 cost-sharing model, the federal government provided the provinces with a lump sum based on a 3-year moving average of the Gross National Product and per capita cash payment. This new arrangement granted provinces more flexibility in allocating funds, allowing them to use federal money for programs beyond insured hospital and medical services, such as extended healthcare in nursing homes or drug-benefit plans not included in Medicare.

Comprehensive coverage

The Hospital Insurance and Diagnostic Services Act (HIDS) is a statute passed by the Parliament of Canada in 1957. The Act was implemented to reimburse one-half of the provincial and territorial costs for hospital and diagnostic services administered under provincial and territorial health insurance programs. The federal funding was coupled with terms and conditions borrowed from the Saskatchewan Hospital Services Plan, which was introduced in 1947 as North America's first universal hospital insurance program.

The Act comprehensively covers all inpatient and outpatient hospital services, as well as diagnostic services, under the insurance plan. This includes acute, convalescent, and chronic care, along with laboratory and radiology diagnostic services, and inpatient drug administration in hospital facilities. However, it is important to note that coverage does not extend to hospitals for tuberculosis, mental hospitals, nursing homes, capital expenditures, or administrative costs.

The Act intrinsically deterred provinces and territories from charging patients for services. Instead, each province and territory was responsible for administering its own plan and deciding how to raise its proportion of funding for the insurance program, either through insurance premiums or taxation. To ensure accessibility, the Act stipulated that services should be reasonably accessible to insured persons without any financial or other barriers, and that provinces and territories should limit co-payments and other "deterrent" fees.

The HIDS Act laid the groundwork for a Canadian health insurance plan, and by 1961, all ten provinces were enlisted. The Act's principles of comprehensiveness, universality, accessibility, and portability were key in shaping Canada's national health insurance program, known as Medicare, which aims to ensure that every resident of Canada receives medical care and hospital treatment.

Universal access

The Hospital Insurance and Diagnostic Services Act (HIDS) was passed by the Parliament of Canada in 1957. The Act was a response to the increasing demand for national comprehensive health insurance. It was the first step towards a Canadian health insurance plan, with the federal government agreeing to fund approximately 50% of the costs of provincial or territorial insurance plans for hospital and diagnostic services.

The Act outlined the principles of comprehensiveness, universality, accessibility, and portability. All-encompassing in-patient and out-patient hospital services, as well as diagnostic services, were to be made available under the insurance plan. This included acute, convalescent, and chronic care, as well as laboratory and radiology diagnostic services.

Universality meant that services were to be made available to all residents of the province or territory. The health care insurance plan of a province had to entitle 100% of the insured persons of the province to the insured health services provided under the plan. This was to ensure that every resident of Canada had access to medical care and hospital treatment, regardless of their ability to pay.

To ensure accessibility, services had to be reasonably accessible to insured persons without any financial or other barriers. Provinces and territories were also obligated to limit co-payments and other "deterrent" fees to ensure that patients were not burdened financially at the point of care.

Portability ensured that provincial plans provided coverage for out-of-province Canadian residents who were insured by their home provincial or territorial plans. This allowed for continuity of care when individuals travelled or moved within Canada.

Provincial administration

The Hospital Insurance and Diagnostic Services Act (HIDS) was enacted in 1957 by the Parliament of Canada to ensure access to essential medical services for all Canadians. The Act reimburses one-half of the provincial and territorial costs for hospital and diagnostic services administered under provincial and territorial health insurance programs. This promotes the administration of universal coverage for a specific set of treatments and procedures under certain terms and conditions.

Provincial and territorial insurance plans were to cover acute, convalescent, and chronic care of patients, including diagnostic services and in-patient drug administration in hospital facilities. However, coverage did not include hospitals for tuberculosis, mental hospitals, nursing homes, capital expenditures, or administrative costs. The Act mandates each province and territory to establish a hospital insurance plan that complies with the principles of universal coverage. These plans cover a wide range of services and work to ensure they are offered in a timely and effective manner.

Provinces and territories were also obligated to limit co-payments and other "deterrent" fees to ensure that patients were not burdened financially at the point of care. The Act intrinsically deterred provinces and territories from charging patients for services. Under the Act, insured services could only be delivered by hospitals, and hospital employees, including physicians, laboratory technicians, and radiologists, were to be paid via a fee-for-service model negotiated with the provincial or territorial administrative body.

The Canada Health Act (CHA) sets out criteria and conditions that provincial and territorial health insurance plans must meet to receive the full cash contribution for which they are eligible under the Canada Health Transfer. The CHA requires that "medically necessary" or "medically required" hospital, physician, or surgical-dental services be insured by the provincial or territorial plan. As a result, some health services that Canadians view as essential to maintaining good health, such as prescription drugs and many mental health services, are not required to be insured by provinces and territories. However, provinces and territories are free to insure other health care services in addition to those prescribed by the CHA, leading to variations in the basket of publicly insured health services across Canada's provinces and territories.

Role of private entities

The Hospital Insurance and Diagnostic Services Act (HIDS) was passed by the Parliament of Canada in 1957 to reimburse half of the provincial and territorial costs for hospital and diagnostic services. The Act was implemented in response to the increasing demand for national comprehensive health insurance. Under the Act, insured services could only be delivered by hospitals, most of which were private entities.

The role of private entities under the Hospital Insurance and Diagnostic Services Act was significant, as they were responsible for providing insured health services to residents of the respective province or territory. Private hospitals employed physicians, laboratory technicians, and radiologists, who were paid through a fee-for-service model negotiated with the provincial or territorial administrative body. This meant that these healthcare professionals were compensated for each service they provided, as outlined in the negotiated agreement.

The private hospitals were required to provide comprehensive services, including inpatient and outpatient care, as well as diagnostic services such as laboratory tests and radiology procedures. The Act also covered drug administration within hospital facilities. However, it is important to note that coverage did not extend to tuberculosis hospitals, mental hospitals, nursing homes, capital expenditures, or administrative costs.

Each province and territory had the autonomy to administer its own plan and decide on the funding mechanism for the insurance program, whether through insurance premiums or taxation. This flexibility allowed them to tailor the program to their specific needs and preferences.

The involvement of private entities in the Hospital Insurance and Diagnostic Services Act was instrumental in ensuring that residents of Canada had access to medical care and hospital treatment, with costs covered through general taxes or compulsory health insurance premiums. This marked a significant step towards providing universal healthcare coverage and reducing financial barriers to accessing essential health services.

Frequently asked questions