On the Hoadley Commission
Wight was well aware of Alberta’s 1928 legislative inquiry that supported a health insurance program and the annual request to the government for a state medicine program that followed. Health Minister Hoadley’s awareness of the Cardston program is unrecorded. Whether it triggered the appointment of the Commission or not, he could not have avoided knowing about it. The commission, in its December 1932 report, determined the coverage of services (doctors, hospitals, drugs and dentists) would require a provincial subsidy if it was to be extended across the province.
On the Cardston program trustees
N.E. Tanner and H. W. Hinman both became longstanding Social Credit cabinet ministers after running successfully in the 1935 election. Wight lost his 1935 election bid as an independent candidate.
He moved to Provo, Utah, and subsequently started Blue Cross of Utah, which still exists. Ten years later Archdeacon Middleton wrote to him. “Your departure … left a distinct gap in the accredited editorial comments … I have missed you – the Town has missed you – the community is lost without you; and the Newspaper lacks the ‘fire’ and leadership of its former Editor [Wight].”
On Cardston and District
The Mutual Improvement Association (MIA) of the LDS Church initially sponsored the program. It became autonomous when the new Cardston Health Society (CHS) took it over in 1938. The program survived the 1948 initiated, physician directed, prepaid Medical Services Incorporated (MSI) program, as its costs were lower (fewer services. no specialists were covered and overhead was lower). From a physician perspective, there were no doctors on the MIA/CHS Board to adjudicate problem cases.
On the province of Alberta
The $25 contract per family per year example spread widely and rapidly throughout rural Alberta. Lethbridge was the most receptive community, signing up many citizens, including mining company employees. The Lethbridge medical leader, Dr. Steve Schmaltz, became the manager of MSI when it started in 1948.
On Dr. A. E. Archer, the AMA/CPSA and the CMA
Archer’s Lamont clinic signed prepaid medical insurance contracts with several local municipalities starting in 1933, creating the Di Bozcha program. After the backlog of care was dealt with, Archer spent the next 10 years encouraging acceptance of the concept of prepaid medical insurance, particularly among physicians. He secured AMA and then CMA support “in principle” for a hospital and medical insurance program in Canada in 1943. It had the same coverage Archer and Dr. W. Wilson had proposed to the Hoadley Commission for Alberta in 1932: doctors and hospitals – the coverage we now have.
On Cardston doctors
Drs. J.K. Mulloy and M.J. Baynton agreed to participate in the program. Their monthly payments were $203 each for the first year. The contract covered all medical care including hospital care. At the end of the first contract period, the doctors offered $25 contracts directly to their patients. Their patients politely declined them. Mulloy also provided medical care to the Cardston Blood Indian Reserve hospital for 18 years, as Chief Running Rabbit, before he left in 1938 to build and manage the Col. Belcher Hospital in Calgary.
While contracts were popular, some families signed for just one year, when the prospective mother became pregnant. Contracts were not transferable if the family left the district.
On the LDS Church
Church leaders looked upon the program as a contribution to the social fabric of their community. Honestly run, it benefitted from gratuitously provided leadership.
On the consideration of the Russian polyclinic (salaried doctors and health clinics) precedent
Wight’s notes mention that “the Russian compulsory health services followed the German [Bismarck] plan,” adding without explanation that the German plan had failed. The AMA resolutely objected to placing doctors on salary.
On the formation of the Co-operative Commonwealth Federation (CCF) political party
Major political upheavals were already underway in Alberta following the resignation of United Farmers’ Association's (UFA) only president Henry Wise Wood in 1931. The “Ginger offshoot group” was formed, which led to the founding of the CCF in Calgary in August 1932. Rev. Tommy Douglas was an original member. In the CCF’s Regina Manifesto of 1933, and as Wight had wanted, it resolved to make health care as accessible as education.
Despite the Cardston program’s obscurity and non-replication, it became an example of what the public would support, a not-for-profit, combined hospital and prepaid medical insurance program, even if they had to pay the full insurance cost of it during the Great Depression. The concept would resonate, reaching an 80% public support level in Canada by 1943.
You can learn more about the Cardston Medical Contracts here.
Banner photo credit: Marvin Polis