On June 13, 1969, the National Assembly assented to Bill 30, thereby establishing the Régie de l'assurance maladie du Québec (RAMQ) with the following mandate: to set up the Québec Health Insurance Plan on July 1, 1970.
Review of the Canadian and Québec health systems
The Hall Commission was constituted in 1961 to conduct a systematic review of the Canadian healthcare system. Issued in 1964, its report charted the course for the governments, both federal and provincial.
In the spirit of the Hall Commission recommendations, Québec adopted the Medical Assistance Act in 1966 to ensure that social assistance recipients had medical care coverage. With the objective of conducting an overall assessment of its own healthcare system, the Québec government established, that same year, the Castonguay-Nepveu Commission, first chaired by Claude Castonguay, then by Gérard Nepveu. In 1967, the Commission proposed implementation of a complete and universal health insurance plan for all Québec residents.
Free access to healthcare
On July 1, 1968, the Medical Care Act came into effect. The Act established a cost-sharing program between the 2 levels of government whereby the federal government undertook to cover half the costs of the provincial and territorial health insurance plans. Targeted provisions were specifically aimed at ensuring free access to healthcare.
RAMQ is created
The provincial government's own efforts culminated on June 13, 1969 with the creation of the Régie de l'assurance maladie du Québec. The government's goal was to respond to the needs of its citizens and implement its own health and social welfare policies, in line with the spirit of the federal policies. Robert Després was the founding president and chief executive officer of RAMQ.
Then Prime Minister Robert Bourassa, with Robert Després and Claude Castonguay.
The Québec Health Insurance Plan comes into effect
With the Health Insurance Plan due to come into effect on November 1, 1970, its architects had 16 months to design, test and set up the administrative structure of a vast system, one that needed to process millions of claims from health professionals and register some 5 million people for the plan.
Using a list of names and addresses obtained from government departments and agencies, RAMQ sent a form to the heads of families to check the accuracy of the information already collected. Those persons not reached could register by filling out a coupon appearing in newspapers. This is how all Québec residents obtained their first Health Insurance Card.
The Health Insurance Card: important dates
The Health Insurance Card is here! White with blue inscriptions, the card is valid for an unlimited period of time. The Health Insurance Number is based on the social insurance number of the head of the family, usually the father.
The card takes on the appearance familiar to us today. It is valid for 4 years, and a unique permanent number is allocated to each person.
The idea of the sunset seen on the Health Insurance Card was devised by Cossette Communication-Marketing, the advertising agency working with RAMQ at the time. The visual impact of the card was such that it eventually became referred to as the "carte soleil."
The photo and signature of the holder appear on the card. A hologram is added to thwart forgeries. The holder can now check a box on the back of the card to consent to organ donation.
The Régie de l'assurance maladie du Québec and the Société de l'assurance automobile du Québec coordinate their operations so that the same photo and signature appear on both the Health Insurance Card and the driver's licence.
The card holder can now consent to organ donation by signing a sticker and affixing it to the back of the card.
Micro printing is embedded in the card.
The size of the photo appearing on the card is increased by nearly 40% to facilitate identification of the holder. A protective layer is added for increased durability.
The Card now has a bar code.
Yesterday and today
RAMQ in the early 1970s...
- More than 4 million persons registered for the Health Insurance Plan
- 10 000 health professionals remunerated by RAMQ
- 17 million claims submitted by health professionals in the first year
- 3 programs delivered (medical services, optometric services and oral surgery)
- 7.6 million persons covered by the Health Insurance Plan, including 3.3 million who are also covered by the Public Prescription Drug Insurance Plan
- More than 36 000 health professionals and service providers remunerated by RAMQ
- Close to 230 million claims submitted annually by health professionals
- Some 40 programs