Prepaid Medical Care and Changing Needs in Saskatchewan

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Abstract
Prepaid plans for general medical care have been developed in Saskatchewan municipalities since 1921 to help assure the services of doctors in isolated villages. In 1945 the provincial government assisted these plans with grants, conditional on meeting standards designed to protect both patients and doctors. In most plans the physician is on salary and all residents of the municipality are entitled to general medical services; in about 40% of plans, major surgery is also included. Membership in the plans expanded gradually to a peak of 200,000 persons in 1950. Since that year voluntary medical care insurance plans, sponsored by Saskatchewan''s organized medical profession, have been established in rural areas. These plans offer free choice of any doctor in the province, paying him on a fee-for-service basis. They are much more expensive than the municipal plans and, being voluntary, fail to cover about 25% of residents in the community. Access to specialists, however, with improving roads and higher provincial income, has made them popular, with steady growth at the partial expense of municipal plan enrolment. A 3rd type of prepayment plan exists in the Swift Current Health Region under which 50,000 people in a large area are provided general medical and surgical care, with free choice of doctor and payment on a fee basis. Costs are higher than the municipal plan rates but lower than the voluntary plan rates. None of these 3 plans is perfect. The municipal plans played an important purpose in attracting doctors to rural areas, but fail to meet complex requirements of modern medicine. The voluntary plans fail to cover all the people and are relatively expensive. The regional plan does not offer comprehensive specialized services. It is likely that full adjustments to both technical and economic needs will depend on province-wide insurance as recommended by the Saskatchewan Health Survey Committee in 1951.