Canada’s National–Provincial Health Program for the 1980’s, the report of the second Hall Commission, was intended to respond to rising public concern that federal and provincial cost control measures during the late 1970s had eroded the core principles of medicare. In the report, Mr. Justice Emmett Hall urged provinces such as British Columbia, Alberta and Ontario to consider eliminating their health insurance premiums once the economy improved to ensure unimpeded access to necessary care. He stated that, “if extra-billing is permitted as a right and practiced by physicians in their sole discretion, it will, over the years, destroy the program” (Malcolm G. Taylor, Health Insurance and Canadian Public Policy: The Seven Decisions That Created the Canadian Health Insurance System and Their Outcomes [Montréal and Kingston: McGill–Queen’s University Press, 1987], p. 429).
The report also noted the importance of shifting attention to health promotion, controlling the number of doctors, permitting nurses and other health professionals to increase the scope of their practice, and responding to the health needs of Aboriginal people and other marginalized groups. The report’s call for binding arbitration to settle billing disputes upset medical associations and provincial politicians, and both groups were hostile to its recommendations. Nevertheless, the report provided the foundation for the Canada Health Act of 1984.