Making Medicare:  The History of Health Care in Canada, 1914-2007 Back to Timeline Back to Timeline
History: 1930-1939 ORIGINS, 1914–1929 DEPRESSION DEVELOPMENTS, 1930–1939 NATIONAL SYSTEM, NATIONAL FAILURE? : WAR, RECONSTRUCTION AND HEALTH SECURITY FOR CANADIANS, 1939–1948



Practice Problems in Urban Canada

In Hamilton, Ontario, urban general practitioners watched with dismay as the volume of services that they were able to perform declined by 36.5 per cent between 1929 and 1932. Even worse, the number of patients who could pay their bills fell from 77.5 per cent in 1929 to 50 per cent in 1932. Most urban general practitioners had a gross annual income of $5,000 to $6,000 and specialists usually earned about double that prior to 1929. But 30 per cent of the money went towards the costs of running a practice and approximately $2,000 was never collected. Of the latter, the doctor realized that $800 in fees would never be collected due to the patients’ poverty, while the remaining $1,200 went towards bad debt. Although some doctors used collection agencies or the threat of legal action to obtain their fees, most were content to pursue a Robin Hood style of billing, which meant that they charged their wealthy patients more than their other clients. During an economic boom, this approach worked, but its flaws became evident during the Great Depression, when doctors were unable to support their own families or continue to care for their patients. Who should take responsibility for resolving this crisis of capitalism?

“Dr. René Coulombe settled in Sainte-Marthe, Quebec, about 1930 ... He never charged for office calls. I asked him one time what he did for a living. He said he charged for house calls, and also made some mark-up when he sold pills and such, from a small pharmacy he kept.”

Philip Garrison, Saint-Polycarpe, Quebec, in Life Before Medicare: Canadian Experiences (Toronto: Ontario Coalition of Senior Citizens’ Organizations, 1995), p. 65.

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    Date Created: March 31, 2010 | Last Updated: April 21, 2010