History of Nursing in Pacific Canada

The Vancouver Medical Association Bulletin: May, 1936 Vancouver Medical Association May 31, 1936

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Full Text

 The BULLETIN
OF THE
VANCOUVER MEDICAL
ASSOCIATION
Vol. XII.
MAY, 1936
No. S
In This Issue:
Health Insurance Bill
LETTER
TO
THE
PROFESSION
NEWS
and
NOTES BULKETTS
(With Cascara and Bile Salts)
. . FOR . .
Chronic Habitual
Constipation
BULKETTS POSSESS ENORMOUS BULK
PRODUCING PROPERTIES AND BEING
PROCESSED WITH CASCARA AND
BILE SALTS PRODUCE BULK WITH
MOTILITY.
WE WILL BE PLEASED TO PROVIDE
ORIGINAL CONTAINERS FOR TRIAL
ON REQUEST.
Western Wholesale Drug
(1928) Limited |
456 BROADWAY WEST
VANCOUVER   -   BRITISH COLUMBIA
(Or at all Vancouver Drug Co. Stores) THE     VANCOUVER     MEDICAL     ASSOCIATION
BULLETIN
"Published ^Monthly under the ^Auspices of the Vancouver ^Medical (Association in the
Interests of the ^Medical 'Profession.
Offices:
203 Medical Dental Building, Georgia Street, Vancouver, B. C.
Editorial Board:
Dr. J. H. MacDermot
Dr. M. McC. Baird Dr. D. E. H. Cleveland
All communications to be addressed to the Editor at the above address
Vol. XII.
MAY, 1936
OFFICERS  193 5-193 6
Dr. C. H. Vrooman
President
Dr. G. H. Clement
Hon. Secretary
Additional Members of Executiv
Dr. W. T. Ewing
Vice-President
Dr. A. C Frost
Past President
Dr. W. T. Lockhart
Hon. Treasurer
-Dr. T. R. B. Nelles, Dr. F. N. Robertson
TRUSTEES
Dr. W. D. Brydone-Jack Dr. J. A. Gillespie Dr. F. Brodie
Auditors: Messrs. Shaw, Salter & Plommer
SECTIONS
Clinical Section
Dr. J. R. NeilsOn —   Chairman
Dr. Roy Huggard   ~  Secretary
Eye, Ear, Nose and Throat
Dr. H. R. Mustard .    — Chairman
Dr. L. Leeson ^  ...Secretary
Pediatric Section
Dr. G. A. Lamont r Chairman
Dr. J. R. Davies  — - ...Secretary
Cancer Section
Dr. J. W. Thomson i. Chairman
Dr. Roy Huggard    Secretary
Library
Dr. G. E. Kidd
Dr. W. K. Burwell
Dr. C. A. Ryan
Dr. W. D. Keith
Dr. H. A. Rawlings
Dr. A. W. Bagnall
Publications
Dr. J. H. MacDermot
Dr. Murray Baird
Dr. D. E. H. Cleveland Biological Products
Anti-Anthrax Serum
Anti-Meningococcus Serum
Anti-Pneumococcus Serum (Type I)
Anti-Pneumococcus Serum (Type II)
Diphtheria Antitoxin
Diphtheria Toxin for Schick Test
Diphtheria Toxoid
Perfringens Antitoxin
Scarlet Fever Antitoxin
Scarlet Fever Toxin for Dick Test
Scarlet Fever Toxin
Staphylococcus Antitoxin
Staphylococcus Toxoid
Tetanus Antitoxin
Tetanus Toxoid
Tuberculin
Pertussis Vaccine
Rabies Vaccine (Semple Method)
Smallpox Vaccine
Typhoid Vaccine
Typhoid-Paratyphoid Vaccine
Heparin
Insulin
Liver Extract for Oral Administration
Liver Extract for Intramuscular Use (1 cc,
containing extract from 10 gms. of liver)
The following additional products have been made available recently
by the Connaught Laboratories
Adrenal Cortical Extract
Epinephrine Hydrochloride Solution 1:1000
Epinephrine Hydrochloride Inhalant Solution 1:100
Liver Extract for Intramuscular Use
(1 cc. Containing Extract from 20 gms. of Liver)
Outfit for Rapid Typing of Pneumococcus by Physicians
CONNAUGHT   LABORATORIES
UNIVERSITY  OF  TORONTO
TORONTO 5 • CANADA
Depot for British Columbia
MACDONALD'S   PRESCRIPTIONS   LIMITED
MEDICAL-DENTAL BUILDING, VANCOUVER, B.C. VANCOUVER HEALTH DEPARTMENT
STATISTICS—MARCH, 1936
Total Population (Estimated)   1  247 558
Japanese Population   (Estimated)     8 05 5
Chinese Population  (Estimated)  7 895
Hindu Population (Estimated) __  320
Number
Total deaths  262
Japanese deaths ,    X
Chinese deaths  9
Deaths—Residents only     237
Birth Registrations—Male, 149; Female, 145     294
February
INFANTILE MORTALITY— March, 1936
Deaths under one year of age       10
Death rate—per 1,000 births       34.0
Stillbirths  (not included in above)  9
Rate per 1,000
Population
12.1
1.4
13.5
11.3
14.0
February
March, 193 5
13
49.2
13
CASES OF COMMUNICABLE DISEASES REPORTED IN THE CITY
April 1st
to 15th, 1936
Cases    Deaths
February, 1936
Cases    Deaths
March, 193 6
Cases    Deaths
Smallpox  0
Scarlet Fever    42
Diphtheria     0
Chicken Pox  56
Measles     68
Rubella   520
Mumps    i  3 57
Whooping-cough       32
Typhoid Fever    2
Undulant Fever    1
Poliomyelitis _. 0
Tuberculosis  56
Meningitis   (Epidemic)    0
Erysipelas      1
Encephalitis Lethargica   0
Paratyphoid Fever  0
High Blood Pressure...
BIOGLAN "H"
rtTbe most effective therapy available "
Formula—Each 1 cc. Ampoule contains:
Pancreas    25 grammes of the fresh hypotensive principle
Anterior Lobe Pituitary 2 grammes of fresh substance
Embryonin  ._/f»T.„; _ 2 grammes of fresh substance
MADE IN ENGLAND BY
THE BOWSHER LABORATORIES LTD.
Biological and Research
Fonsbottrne Manor, Hertford, England.
Rep., S. N. BATN-
1432 Medical Dental Building       Phone Sey. 4239       Vancouver, B. C.
References: "Ask the Doctor who has used it."
ilft
Page 167 An Effective Remedy lor all   -
Staphylococcal Infections
In bottles of 80 tablets. Dose: 2 tablets three times a day.
For Boils, Carbuncles,
Acne, Styes, etc. -yJ
In bottles of 80 tablets. Dose: 2 tablets three times a day.
Literature and Sample front:
ANGLO-FRENCH
DRUG CO.
MONTREAL, CANADA
Obtainable from: B. C. Drugs Limited, Vancouver VANCOUVER MEDICAL ASSOCIATION
Founded 1898 :: Incorporated 1906
Programme of the 3 8th Annual Session
-    GENERAL MEETINGS will be held on the first Tuesday of the month
at 8 p.m.
CLINICAL MEETINGS will be held on the third Tuesday of the month
at 8 p.m.
Place of meeting will appear on Agenda.
General Meetings will conform to the following order:
8:00 p.m.—Business as per Agenda.
9:00 p.m.—Paper of the evening.
1935.
October 2nd—GENERAL MEETING.
Dr. G. F. Strong: "Cardiac Pain."
Discussion opened by Dr. H. A. DesBrisay.
Dr. A. M. Agnew: "Vaginal Plastic Surgery."
Discussion opened by Dr. J. J. Mason.
October 15 th—CLINICAL MEETING.
November 5th—GENERAL MEETING.
Dr. J. R. Naden: "Epiphyseal Injuries."
Discussion opened by Dr. F. P. Patterson.
Dr. J. H. MacDermot: "Early Medical History of the B. C. Coast."
November 19th—CLINICAL MEETING.
December 3rd—GENERAL MEETING.
Dr. Lyall Hodgins: "Diabetes."
Discussion opened by Dr. Wallace Wilson.
Dr. Frank Turnbull: "The Early Diagnosis of Brain Tumours."
Discussion opened by Dr. F. W. Emmons.
December 17th—CLINICAL MEETING.
1936.
January 7th—GENERAL MEETING.
Dr. Walter M. Paton: "Tumours of the Head and Neck."
Discussion opened by Dr. H. H. Pitts.
Dr. B. J. Harrison: "Roentgenology of Cardiac Diseases."
Discussion opened by Dr. G. F. Strong.
January 14th—CLINICAL MEETING.
February 4th—GENERAL MEETING.
Mr. J. W. deB. Farris: "Medico-Legal Problems."
February 18 th—CLINICAL MEETING.
March 2nd—OSLER LECTURE.
April 7th—GENERAL MEETING.
Dr. C, E. Dolman: "Serum Therapy."
Discussion by Dr. Howard Spohn and Dr. A. Y. McNair.
April 21st—CLINICAL MEETING.
April 28th—ANNUAL MEETING.
Page 168
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15 *
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'. * EDITOR'S PAGE
We publish herewith a copy of the Health Insurance Bill, which, after
suffering many things, like Ulysses, has at last been passed at the recent
sitting of the Legislature.
There has been some criticism directed at the medical profession over
this Bill, and it would be idle to deny the fact; but we do not think the
criticism is necessarily well-founded.
We have been criticised for opposing the Bill. Well, we admit that freely.
The original draft Bill was not in any way perfect; in many ways it was
bad; but it was a long way better than this one. It did purport to look after
all the members of the community whose yearly income, whether from
indigence or low wages, fell below a certain level. It did acknowledge the
fact that the Government should contribute to the Act, by at least half
the lost of administration.
It did acknowledge the medical profession. It seemed to recognise the
fact that medical men will be necessary in the working of this Act, and it
gave us a certain amount of say in the administration of the Act. It did
make some attempt to ensure that the income obtained from assessments,
etc., would more nearly meet the necessary outgoings.
But gradually, under the pressure, not of clearer knowledge and riper
judgment, but of political necessity, this Bill was pruned and shorn of these
characters—till after a battle, never equalled, as we believe, in these parts
at least, the Bill has emerged, a sorry enough spectacle.
For it is a pale shadow of its former self, ana_mic and paralysed in its
lower limbs, or lower income-levels, if you prefer. It no longer makes a
pretence at humanitarianism, which we were led to believe was the main
impulse animating its progenitors. The indigent, the domestic servant, the
casual labourer, the part-time worker, those in receipt of old-age and
mothers' pensions, in fact all the people who really need medical aid the
most, and cannot afford it at all, are or may be excluded. The Government's
contribution is removed. The contributions from those who do pay are not
sufficient, on any calculation, to give what we would consider to be an
adequate medical service.
We have been criticised, as a profession, for opposing this Bill, because
it has been said of us that our reason for opposing it is that our remuneration is too low. It is quite true that this is one of our reasons—and tpere is
nothing criminal in trying to get adequate pay for the work expected of us.
The amount originally set aside for this purpose would mean economic
slavery for the majority of medical men, and we do feel that we have a
right to oppose this. The upper limit has been removed, and there may be
now some room to bargain—but even so, this is not our main reason for
objecting to this Bill.
Our main reason is that we know that this Bill will not give what was
promised, to those who come under it, namely, a complete and adequate
medical service. Those who think it will are due for a major disappointment.
No partial Health Insurance Bill, such as is this, or those in effect in England
and Germany, has ever given, or will ever give, a good service. It is true
that this Bill promises specialist service, but it does not provide funds to
give it, and it is governed by two pernicious principles. The first is that if
enough money is not obtainable, medical benefits will be reduced; the
second is that if there is not enough money to pay adequately for all the
Page 169 I
service given, a reduced rate of pay must be accepted. We confess that we
cannot remember ever having heard of a contract of any sort or description
being signed on these terms.
We have been criticised as a profession for not giving our views to the
public before this, while radio, press, pulpit, and University class-room have
.been freely conscripted and used without stint for purposes of propagation
of the new gospel.
Our reasons for this are old-fashioned, but we believe good ones, notwithstanding. We wanted to play fair. We might long ago have expressed
ourselves—but there was no definite statement, only "memoranda," and we
did not feel that we were right in attacking anyone on suspicion, or through
mistrust of their motives, until definite legislation was brought down.
But we think as medical men we are justified in pointing out to those
who may, as many of our friends still do, ask our opinion of this legislation.
We may rightly warn them of the following dangers as we see them; the
following defects in this Bill:
First, the danger to industry—the economic threat of this Bill, provincial
in scope, applied at a time when industry is gasping for life, and has to
compete with stronger, more established industry elsewhere.
The danger, almost the certainty, that, the assessments will not be
enough, and will very soon have to be raised. This is the history of all such
social legislation. Workmen's Compensation Acts, Old Age Pensions,
Mothers' Pensions, Social Service—all these cost more and more as the years
go by—and we are sure this will be no exception.
The danger of poor, hurried, inadequate medical service and the lowering of medical standards of practice. Anyone who knows anything about
panel practice in Great Britain knows that its standard is deplorably low—
and we fear that the tendency under this Bill will be in the same direction.
Certainly, under a capitation system of payment, there would be grave
danger of this.
The absence of any preventive measures designed to lessen disease.
The exclusion of the indigent and those whose income is uncertain and
very small. This is one of the worst defects of this Bill.
The inadequacy of hospital arrangements. This has been consistently
ignored, though hospital authorities have been most definite in their
warnings.
We have been accused of opposition to health insurance. This is not
true. We are unanimously in favour of health insurance and that is why
we do not like this legislation. We foresee nothing but disillusionment and
disappointment over this Bill, which, we were told, was to be so far in
advance of all such legislation—and, in the last analysis, has turned out to
be no better than the average old-time legislation.
In its study for many years of Health Insurance the medical profession
has gradually formulated a series of principles which it believes should
govern any Health Insurance scheme.
The basic object of these principles is to safeguard both our own interests and those of the public who would benefit under the Act, and we
believe that both these things are essential. Thus we believe that the indigent should be included and those of very small income; that prevention
should be a major feature in this type of legislation; that doctors should
be paid for services rendered, and not according to a capitation fee and so
on. We have not seen any reason to change our minds in these matters—
Page 170 m
and believe that if the public demands and is to obtain adequate, modern,
and scientific medical service, these principles must still be maintained.
Lastly, we feel we must say a word about the work of Dr. W. H.
Sutherland, M.L.A., in regard to this Bill, as it passed through Committee.
His attitude has been worthy of the highest praise. He shewed firmness and
dignity, a due sense of the amenities, and a true respect both for the House
and for the profession he represented. In the record as we have seen it, he
refused steadily to yield to expediency, or to sacrifice his principles, and
we congratulate him sincerely on his conduct in a very trying situation.
NEWS AND NOTES
Dr. W. E. Ainley, chairman of the Health Insurance Committee of the^
Council of the College of Physicians and Surgeons, has asked the Bulletin
to point out that the response of members to the questionnaire sent out as
regards incomes is still very unsatisfactory and incomplete, some 3 5 % only
having responded so far.
This is a most important part of our study of this whole question of
medical economics. Any information given is quite confidential—even the
name of the giver will not be known—and no possible harm can come of
the fullest frankness.
We again urge all members of the profession to complete their form
and mail it at once.
Dr. Ainley's statement follows:
On March 14th a circular letter was sent to all doctors in the Province
stating that the Health Insurance Committee was making a study of the
incidence of disease in the Province, and estimating the amount of work
done by the profession.
We also wanted information regarding gross and net incomes, and how
obtained, so that we would correlate the work and the remuneration and
thus obtain valuable information.
The results have been as follows to date:
Letters Income Names °/o Income % Names
sent returns given given            given
Vancouver     3 54                111                78 31 22
Victoria          63                  25                16 40 25
Other places       269                104               93 39 31
Total      686               240              187 3 5 27
Your co-operation in this study was earnestly requested. The results
are discouraging and the large amount of work done is rendered largely
useless. We need at least 75% return and should have 100%. Should Health
Insurance come into force probably other studies will be desirable, but what
is the use of undertaking work for the good of the profession, when the
latter will not take the small amount of trouble necessary to help? Possibly
the delinquents will take this to heart, and send in their information This
is your own business; we can do no more about it.
W. E. Ainley, Chairman.
Amongst our advertisements in this and the next issue will be noticed
the announcement of the forthcoming meeting of the Pacific Northwest
Medical Association, to be held in Portland, Oregon, from July 8-11 inclusive.
Page 171 The list of speakers is a guarantee that this meeting will be an excellent
one, and well worthy of attendance by any medical man. One notices perhaps especially the name of Chevalier Jackson, that great exponent of the
art of bronchoscopy, in whose hands it has indeed developed into one of the
great branches of the tree of medicine.
We are happy to give our support to this meeting, and to call it to the
attention of all our readers.
LETTER TO ALL MEMBERS OF THE MEDICAL
PROFESSION IN B.  C.
Dear Doctor:
In this issue of the Bulletin you will find a verbatim copy of the
Health Insurance Act as passed by the Provincial Legislature on March
31, 1936.
The Health Insurance Committee has been delayed in reporting to the
members of the medical profession by various causes: the first being that
it was felt desirable that every medical man should have a copy of the Act
to study for himself. This is our reason for printing this Act in extenso;
as it would have been extremely difficult to obtain the six or seven hundred
copies necessary in any other way.
We ask that everyone study this Act carefully, and note the following:
It will not come into effect until it is proclaimed by the Lieutenant-
Governor in Council, and probably this will be done in sections: the first
section dealing with the appointment of a Commission to set up machinery,
draft regulations, arrange methods of payment with doctors, hospitals, etc.,
and determine forms of treatment for those benefiting under the scheme.
The Commission has been given wide powers both as to the extent and
nature of the benefits to be given, and the amount of remuneration to be
paid.
It is our definite understanding, both from statements of the Hon. G.
M. Weir in Committee, and from legal opinion, that no medical man can
be compelled to provide service under this Act unless he so desires. If he
agrees to do so, he is subject to regulation, but until and unless he so agrees,
he is a free agent.
The Committee is strongly of the opinion that it would be unwise for
the profession to take any definite stand as to working under this Act until
the regulations have been made known, and until we know what the Government will suggest with regard to the services to be rendered, and the
remuneration that will be offered. When these are known, the Committee
will study them carefully, and will be prepared to make definite recommendations to the profession. No action of any sort will be taken by the
Committee without the full knowledge and endorsement of the profession
throughout the Province, through the Council and through accredited
representatives of the various sections.
In the meantime, the Committee wishes to take this opportunity of
thanking the medical men for their loyalty and unqualified support during
the difficult year that has just passed. It realises the strain and anxiety that
have been felt by all medical men, and it has been conscious of this, and has
been doing its best to conserve the interests of the profession. It has received
pledges of support, and assurances of united action from every district.
Direct canvass of every man has shewn almost complete unanimity, and it
is of the greatest possible importance that this should continue to be the
Page 172
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t- case. Especially during the next few months will our solidarity be tested,
and it must not fail. Sooner or later we shall be called on for decision, and
we must act as a united body.
The upper limit of money available to pay doctors has been removed,
and this, in the opinion of the Committee, renders the Bill somewhat more
elastic, and makes negotiations possible.
We believe that there is still room for negotiation, and that terms
satisfactory to both parties can be arranged—but this can only be secured
if we act as a unit.
Independent action on the part of any medical man can only lead to
disaster for himself as well as for all the members of the profession; and we
most earnestly ask any medical man who may be approached with a view
to action under this Act to refer to the Committee at once. We must make
it clear that we are acting as members of a united profession, not individually.
A study of the Act and especially of the comments on it in a separate
column, will, we believe, convince any man that unity is most urgently
necessary, if our standards of practice and living are to be maintained, and
if adequate medical service is to be secured for the beneficiaries under this
Act.
There will, at a very early date, be opportunities given for the freest
possible discussion of this bill, and of our future policy. Open meetings,
whether luncheon meetings or afternoon meetings, will be arranged; speakers familiar with the Act will lead the discussions, and everyone will be given
an opportunity to express his views, to ask questions, and to contribute
suggestions.
In the meantime, your committee has closely reviewed the Act, and is
ready, as soon as opportunity offers, to indicate clearly and definitely to the
profession what line it thinks should be followed. This will, of course,
depend upon the suggestions and proposals that will be made to us by the
Commission, and every effort will be made to obtain an amicable and satisfactory understanding, on terms that are fair and equitable to all.
Yours truly,
W. E. Ainley, Chairman.
We reproduce here the Health Insurance Bill, which will become law
on proclamation, when the Cabinet decides on this.  (Ed.)
No. 26.] rSlJLL/, [1936.
An Act to provide for the Establishment of a
Provincial System of Health Insurance.
His Majesty, by and with the advice and consent of the Legislative
Assembly of the Province of British Columbia, enacts as follows:—
PRELIMINARY.
Short title.
1. This Act may be cited as the "Health Insurance Act."
Interpretation.
2. In this Act, unless the context otherwise requires:—
"Benefits" means the benefits for insured persons which are specified
or provided under Part III.:
Page 175
m
mmd "Commission" means the Health Insurance Commission constituted under this Act:
"Contribution week" means any calendar week or part of a calendar week for which an employee who is an insured person within
the scope of section 4 is entitled to receive remuneration from
his employer; except that a calendar week in which an employee
is entitled to receive remuneration from two or more employers
shall be counted as one contribution week; and "contribution
week" includes any other week designated by the Commission,
pursuant to the provisions of subsection (5) of section 8, as
a contribution week in respect of an employee:
"Dependents," with respect to any employee or other person, means
every person who is wholly or mainly dependent for support
upon the employee or other person, and who is resident in the
Province, and who is:—
(a.)  The wife of the employee or other person; or
(b.)  The husband of the employee or other person; or
(c.)  The natural or adopted child of the employee or other
person, and under the age of eighteen years; or
(d.) The natural or adopted child of the employee or other
person, between the ages of eighteen and twenty years, inclusive, if dependent upon them for support; or
(e.) The natural or adopted child of the employee or other
person, and over the age of eighteen years, and unable because
of mental or physical incapacity to support himself; or
(/.) Any other member of the family or household of the
employee or other person who is designated as a dependent by
the Commission:
"Employee" means any person who is in receipt of or entitled to
any remuneration for labour or services performed for another:
"Employer" includes every person directly or indirectly responsible
for the payment or providing of the remuneration of an employee, and in respect of an employee in the service of the
Crown in right of the Province includes the Crown:
"Fund" means the Health Insurance Fund established under this
Act:
"Insured person" means any employee or other person within the
scope of Part I. who is registered or is entitled to be registered
as an insured person under this Act, and any dependent of an
employee or other person so registered who is also registered or
entitled to be registered under this Act. Insured persons who are
employees and their dependents within the scope of section 4
shall be known as "employee insured persons." Insured persons
who are persons and their dependents within the scope of section
5 shall be known as "voluntary insured persons":
"Medical services" includes all services and supplies designed for
the prevention, cure, or alleviation of illness, injury, or physical
or mental defect:
"Pharmacist" means any person registered under the "Pharmacy
Act" as a licentiate pharmaceutical chemist:
"Physician" means any person registered under the "Medical Act":
"Prescribed" means prescribed by this Act or the regulations:
Page 174 (&
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"Remuneration" means every form of compensation which an
employee receives or is entitled to receive from an |mployer in
return for labour or services performed for the employer, and,
without restricting the generality of the foregoing, includes
wages, salaries, commissions, fees, bonuses, and the reasonable
money value of board, rent, housing, lodging, or similar perquisites or emoluments:
"Resident in the Province," in respect of any person, means that the
person has his main place of abode in this Province.
Division of Act into parts.
3. This Act is divided into five parts, as follows:—
Part. Section.
I.    Insured Persons       4—6
II.    Health Insurance Fund      7-14
III. Benefits     ■_   15-23
IV. Administration    24-43
V.    Commencement of Act *  44
PART I.—Insured Persons
Employee insured persons.
4. (1.) On and after a date to be fixed by the Commission and to be
approved by the Lieutenant-Governor in Council, every employee who is
resident in the Province and whose rate of remuneration is not greater than
one thousand eight hundred dollars per annum shall become and be an
insured person and his dependents shall become and be insured persons under
this Act.
Exemption of certain employees.
(2.)   The provisions of subsection (1) shall not apply to:—
(a.)   Agricultural employees:
(b.) Any employee holding a certificate of exemption pursuant
to subsection (3 ) :
(c.) Any employee who is a member of an industrial medical-
service plan the members of which are exempt pursuant to
subsection (4).
Certificate of exemption of Christian Scientists.
(3.) Where an employee otherwise within the scope of this section
makes application for exemption in the manner prescribed by the regulations, and establishes to the satisfaction of the Commission that he is an
adherent or member in good standing of the Christian Science Church, the
Commission shall grant to him a certificate of exemption from the provisions of this Act; but, subject to the regulations, such certificate may be
cancelled at the request of the employee or on the employee ceasing to be
an adherent or member of that Church.
Order exempting members of medical-service plan.
(4.) In case of any industrial medical-service plan which was in operation on the first day of January, 1936, and which at that time was operated
primarily for the benefit of the employees of a single employer, and embraced
within its membership at least seventy-five percentum of the employees of
that mployer, and provided for its members at least the services of a physician for all cases of ordinary illness, or such other medical services as in the
opinion of the Lieutenant-Governor in Council were equivalent to such
services, the employees of that employer otherwise within the scope of this
Page 175 section who are members of that industrial medical-service plan shall be
exempt from the provisions of subsection (1) if, at the date when this
section becomes effective, they and their dependents, in the opinion of the
Lieutenant-Governor in Council, under the continuation and development
of their industrial medical-service plan, are reasonably assured of at least
the services of a physician for all cases of ordinary illness and of hospital
-care therefor, or of such other medical services as in the opinion of the
Lieutenant-Governor in Council are equivalent to those services; but if a
majority of the employees of that employer otherwise within the scope of
this section who are members of that industrial medical-service plan vote
to come within the scope of this Act, by secret ballot, at a plebiscite of
those employees taken at any time after the commencement of this Act
pursuant to an Order of the Lieutenant-Governor in Council therefor made
on the request of bona-fide representatives of those employees, or if it is
established to the satisfaction of the Lieutenant-Governor in Council that
those employees and their dependents are not in receipt of medical services
equivalent to the services of a physician for all cases of ordinary illness and
of hospital care therefor, the Lieutenant-Governor in Council may by Order
declare that those employees shall be subject to the provisions of subsection (1).
Power to make exemptions.
(5.) Subject to the approval of the Lieutenant-Governor in Council,
the Commission may from time to time and for any period of time exempt
any or all of the following classes of employees from the provisions of subsection (1):—
(a.)  Domestic servants employed in private households:
(b)   Casual employees, that is to say, those whose employment is
irregular and for short periods of time:
(c.)  Part-time employees:
(d.) Employees in designated establishments, industries, or
localities, and other employees whom, in the opinion of the
Commission, it would be unnecessary or inexpedient to
hold within the scope of this Act.
Extension of provisions to members of certain medical-service schemes.
(6.) Subject to the approval of the Lieutenant-Governor in Council,
the Commission may extend the provisions of subsection (1) to employees
resident in the Province whose rate of remuneration is greater than one
thousand eight hundred dollars per annum but less than three thousand dollars per annum, if such employees were on the first day of January, 1936,
members in good standing of any industrial medical-service plan which
ceases to provide medical services for its members after this section becomes
effective.
Voluntary insured persons.
5. After a date to be fixed by the Lieutenant-Governor in Council, in the
case of any person resident in the Province who is not an employee insured
person, if he makes application to the Commission to become a voluntary
contributor under this Act, the Commission may admit that person to
become and be an insured person and his dependents to become and be insured
persons under this Act, subject to provisions of this Act and to such conditions as the regulations may prescribe.
Registration of insured persons.
6. Every person who becomes an insured person under this Act shall
Page 176 I it
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be registered in the records of the Commission as an insured person in such
manner as the regulations may prescribe, and shall continue to be so registered and to be an insured person so long as he continues to be eligible to
receive benefits in accordance with the provisions of section 18 or 19.
PART II.—Health Insurance Fund.
Creation of Fund.
7. To meet the costs of all benefits provided and all salaries, outlays,
and expenses incurred or payable under this Act there shall be constituted
a Fund, to be operated by the Commission and to be known as the "Health
Insurance Fund," in which shall be placed all moneys received from contributions made by insured persons and employers and all other moneys and
income received by the Commission. The Commission shall deposit all
moneys paid into the Fund in one or more chartered banks to the credit of
the Commission.
Employees' contributions.
8. From the remuneration from time to time payable to each employee
who is an insured person within the scope of section 4 his employer shall
cause to be deducted an amount calculated at the rate of two per centum
of the amount of the remuneration, except that:—
(a.)   The amount to be deducted shall not be less than thirty-five
cents per contribution week, unless a smaller amount is prescribed by the Commission with the approval of the Lieutenant-
Governor in Council; and
(b.)   The amount to be deducted shall not exceed seventy cents per
contribution week.
The employer shall, at such times and in such manner as the regulations may
prescribe, pay over to the Commission the amount so deducted as a contribution from that employee to the Fund.
Employers' contributions.
(2.) Every employer who is required to make a deduction from the
remuneration of an employee pursuant to subsection (1) shall forward to
the Commission with the contribution of his employee an amount calculated at the rate of one per centum of the amount of the remuneration
payable to the employee as the employer's contribution to the Fund in
respect of that employee, except that:—
(a.)   The amount of the employer's contribution shall not be less
than twenty cents per contribution week in respect of the
employee, unless a smaller amount is prescribed by the Commission  with  the   approval  of  the  Lieutenant-Governor  in
Council; and
(b.)  The amount of the employer's contribution shall not exceed
thirty-five cents  per  contribution week  in respect  of  the
employee.
Where the Crown is the employer the contribution shall be paid by the
Minister of Finance from moneys appropriated for that purpose by the
Legislature, or if no appropriation is available for that purpose, from the
Consolidated Revenue Fund.
Money value of emoluments.
(3.)  Where the remuneration payable or provided by an employer to
an insured person consists in part of board, lodging, housing, or other
emoluments, perquisites, or provileges reducible to a money value,  the
Page 177 employer shall notify the Commission of the particulars thereof, and the
Commission may approve or fix an amount which shall be deemed to be
the money value thereof for the purposes of this Act.
Employee with two or more employers in one week.
(4.) Where an employee has more than one employer in any calendar
week, the total amount of the employee's contribution and the total amount
of the employers' contributions shall not be greater than the amounts of
the recpective contributions that would have been deductible or payable if
the employee had had only one employer in that week, and the regulations
may prescribe that the total amount of the employers' contributions shall
be payable by the first employer in that week or by any other of the employers in that week, or that part of the amount shall be payable by each of
the several employers.
Special cases.
(5.) Where an employee has no regular employer or has a number of
employers, or where the remuneration which is payable to an employee fluctuates considerably from time to time because of seasonal or irregular
employment, the Commission, subject to the approval of the Lieutenant-
Governor in Council, may fix rates of contribution for the employee and
his employers, and may prescribe the times and methods of deduction, payment, and remittance of moneys to the Commission other than and in substitution for the rates, times, and methods prescribed in subsections (1) and
(2), except that the rates of contribution so fixed shall not in any case
make the employee liable to a total contribution greater than thirty-six
dollars or his employer or employers liable to a total contribution greater
than eighteen dollars in respect of any period of fifty-two consecutive
weeks. The Commission may specify that the contribution of the employee
shall be in respect of any number of weeks, whether the employee is entitled
to receive remunration for labour or services performed within these weeks
or not, and the weeks so specified shall be deemed to be contribution weeks
in respect of the employee.
Liability of employers respecting employees' contributions.
(6.) In case an employer who is liable to pay a sum of money to the
Fund as contributions in respect of an employee and himself fails to deduct
the amount of the employee's contribution from the remuneration payable
to him, pursuant to the provisions of this section, the employer shall nevertheless be liable to pay the amount of the employee's contribution, as well as
his own, to the Fund.
Liability for payment of contributions where the employer is a contractor.
9.  (1.)   Where an employer who is liable, under this Act, to pay a sum
of money to the Fund as contributions in respect of an employee and himself is:—
(a.) A contractor who performs work for any municipal corporation, or for any board or commission having the management
of any work or service operated for a municipal corporation,
the amount of the contribution may be paid by the corporation, board, or commission, as the case may be, and the amount
paid may be deducted from any moneys due the contractor in
respect of such work:
(b.) A contractor who performs work for any person, both the
contractor and the person for whom the work is undertaken
shall be liable for the payment of the contributions, and the
Page 178
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amount of the contributions may be levied upon and collected
from either of them, or partly from one and partly from the
other; but in the absence of any term in the contract to the
contrary the contractor shall, as between himself and the person for whom the work is performed, be primarily liable for
such contributions:
(c.)  A sub-contractor who performs work for a contractor, both
the sub-contractor and the contractor shall be liable for the
payment of the contributions, and the amount of the contributions may be levied upon and collected from either of them,
or partly from one and partly from the other; but in the absence of any term in the sub-contract to the contrary the subcontractor shall, as between himself and the contractor, be
primarily liable for such contributions.
(2.)   The liability of any person for whom work is done in respect of
any contributions to the Fund required by this Act to be made by any
contractor or sub-contractor shall cease and determine within thirty-one
days after the completion of the contract, unless the Commission within
such time mails to the owner a notice of its claim by prepaid registered post
addressed to the owner at his last-known address:
(„) The notice shall state the amount claimed and the name or
names of the contractor or sub-contractor primarily liable for
such payment.
Prohibition of improper deductions from wages.
10. No agreement by an employee to pay any portion of the contribution required to be paid by his employer under this part shall be valid, and
no employer or other person shall make a deduction for that purpose from
the wages of an employee, or in any other manner collect from an employee
any portion of the contribution required to be paid by his employer.
Contributions of voluntary insured persons.
11. Every voluntary contributor who becomes an insured person under
section 5 shall in accordance with the regulations make such contributions
to the Fund as the Commission, subject to the approval of the Lieutenant-
Governor in Council, may determine; but the rates of contribution shall be
so determined that the total of the contributions to be made by the voluntary contributors shall be sufficient to cover the total costs of providing all
benefits for voluntary insured persons and the administration expenses incidental thereto.
Investment of moneys in Fund.
12. The Commission shall, subject to the approval of the Minister of
Finance, cause all moneys in the Fund in excess of current requirements to
be invested and reinvested in any securities which are under the "Trustee
Act" a proper investment for trust funds. At least every three months, or
at such times as the Minister of Finance may require, the Commission shall
account to the Minister of Finance for all moneys so invested, furnishing
proper vouchers therefor. All investments shall be made in the names of the
Commission and the Minister of Finance jointly, and all interest on investments shall be payable to the Commission and shall form part of the Fund.
Accounting.
13. Separate accounts shall be kept by the Commission of the moneys
received and expended to provide benefits for employee insured persons and
voluntary insured persons, respectively; but for the purpose of paying the
Page 179 costs of all benefits, outlays, and expenses under this Act, the Fund shall,
nevertheless, be deemed one and indivisible.
Audit of accounts.
14. The accounts of the Commission shall be audited by the Comptroller-General or by an auditor appointed by the Lieutenant-Governor in
Council for that purpose, and the salary or remuneration of the last-mentioned auditor shall be paid by the Commission.
PART III.—Benefits.
Mandatory benefits.
15. (1) Subject to the provisions of this Act and the regulations, the
Commission shall provide benefits for insured persons as follows:
(„.)   The services of a physician when required for preventive, diagnostic, or therapeutic treatment and care, including prenatal
and maternity treatment for women and surgical and specialist
services, as may be necessary:
(b.)  Necessary hospital maintenance and care in a public ward,
including drugs, medicines, and dressings, and all other services
which the hospital is equipped to provide; but such hospital
maintenance and care shall be provided for an insured person
for not more than ten consecutive weeks for any one illness,
unless a longer period is prescribed by the regulations: Provided
that where an insured person chooses to avail himself of semi-
private or private ward care or other hospital services more
costly than those authorized under this clause and the regulations, the Commission shall apply towards the payment of the
hospital bill of that insured person an amount equal to the cost
of providing the benefits to which he would otherwise have
been entitled to under this clause:
(c.)   Necessary drugs, medicines and dressings; subject to the provisions of the regulations, which may require that a part, not
exceeding one-half, of the cost of such drugs, medicines and
dressings shall be borne by insured persons:
(d.)   Necessary laboratory services and diagnostic aids, including
X-ray, biochemical, and other services.
Permissive benefits.  .
(2.)  To the extent that the resources of the Fund permit, the Commission may provide for insured persons such medical services, additional
to those specified in subsection (1), as it considers to be valuable to protect
and advance their health and well-being.
Regulations affecting benefits.
(3.) Subject to the approval of the Lieutenant-Governor in Council,
the Commission may make regulations to limit or to specify and define in
greater detail the nature and extent of the various benefits authorized in
subsections (1) and (2); to specify standards of service to insured persons
to be observed by physicians, hospitals, laboratories, pharmacists, and other
persons rendering such service; to prescribe that the provision of certain
medical services shall be subject to small charges being borne by insured
persons; and to designate the manner in which and the conditions upon
which and the place at which benefits shall be granted.
Certain services excluded.
16. The benefits to be provided for insured persons shall not include
Page 180 any services for the diagnosis and treatment of tuberculosis, venereal diseases, nervous and mental diseases, or other diseases or conditions requiring
medical treatment, when such services are otherwise available to insured
persons free or at nominal charges through any public or governmental institution or organization.
Exclusion from benefits where other provision available.
17. Where in respect of any sickness or injury an insured person:—
(a.)  Is in receipt of or is entitled to receive under any other Act of
the Legislature or of the Parliament of the Dominion, or
through any public or governmental institution or organization, treatment, care, or service similar to that which the
Commission is authorized to provide by way of benefits under
this act; or
(b.) Is entitled to recover the cost of such similar treatment, care,
or service by virtue of a claim against any other person for
causing the sickness or injury,—
no benefits shall be provided for that insured person under this Act in
respect of that sickness or injury, except as the Commission may direct in
case of urgent need.
Employee insured persons' eligibility io receive benefits.
18. (1.) Where an employee first becomes an insured person under this
Act, he and his dependents (if any) shall not become eligible to receive
benefits under this Act until after the expiration of four weeks from the
time the employee became an insured person, nor until contributions to the
Fund from the employee for four contribution weeks have become deductible and payable; but after becoming eligible to receive benefits he and his
dependents shall continue to be eligible during each succeeding contribution
week in respect of the employee; and:—
(a.)  For four additional calendar weeks; and
(b.) For such further additional period as may be determined by
the Commission, subject to the approval of the Lieutenant-
Governor in Council.
(2.) Where an employee who, having ceased to be eligible to receive
benefits pursuant to the provisions of subsection (1), again becomes an
insured person, he and his dependents shall not become eligible to receive
benefits until after the expiration of one week from that time, nor until
contributions to the Fund from the employee for one contribution week
have become deductible and payable; but after again becoming eligible to
receive benefits in this manner he and his dependents shall continue to be
eligible during each succeeding contribution week in respect of the employee;
and:—
(a.)   For one additional calendar week; and
(b.) For such further additional period as may be determined by
the Commission, subject to the approval of the Lieutenant-
Governor in Council.
(3.) Where an employee, who, having ceased to be eligible to receive
benefits pursuant to the provisions of subsection (1) or subsection (2), is
unable, because of sickness or inujry, to engage in any employment, as may
be determined by the Commission, he, but not his dependents, shall be
eligible to receive benefits for a further additional period not to exceed
twelve weeks, unless a longer period is prescribed by the regulations; and
Page 181 the regulations may prescribe that the employee's dependents shall be
eligible to receive benefits for the same period as the employee.
Voluntary insured persons' eligibility to receive benefits.
19. Voluntary insured persons shall become eligible to receive benefits
under this Act and shall continue to be eligible in accordance with such
conditions as the Commission, subject to the approval of the Lieutenant-
Governor in Council, may determine.
Right of insured persons to choose physician and pharmacist.
20. Without in any way limiting the power of the Commission under
this Act to provide benefits for insured persons in such manner as it may
consider expedient, the Commission shall, in all cases where it considers the
circumstances do not require the exercise of such power in order to procure
prompt, efficient, and economical medical service for the insured person, permit medical service to be administered, so far as the selection of physician or
pharmacist is concerned, by the physician or pharmacist who may be selected
or employed by the insured person, to the end that so far as possible all
competent physicians and pharmacists without distinction may be employed
and be available to insured persons.
Arrangements and payments for medical services.
21. (1.) Subject to the provisions of subsection (2), the Commission
shall make all arrangements necessary to provide the benefits which insured
persons are entitled to receive under this Act, and shall arrange for the payment of the costs of such benefits. The fees or charges for benefits furnished
and for travelling expenses incurred in providing such benefits under this
Act shall not be more than would be properly and reasonably charged the
insured person if he were paying them directly, and the amount thereof
may be fixed and determined by the regulations, and no action for any
amount larger than that fixed by the regulations shall lie in respect of such
benefits.
Methods for remunerating physicians.
(2.)   Any one of the following methods may be used for remunerating
physicians who provide the services set out in clause (a) of subsection (1)
of section 15:—
(a.)  A salary system:
(b.) A per capita system whereunder the physician is paid at the
rate of a fixed amount per annum for every insured person
eligible to receive benefits for whom the physician has
accepted the responsibility of providing services:
(c.) A fee system whereunder payment is based upon the extent
and character of the services rendered; but where this system
is adopted the total expenditures for any one year for the
services of physicians shall not exceed a fixed rate per annum
per insured person eligible to receive benefits, to be prescribed
by the regulations, multiplied by the average number of
insured persons eligible to receive benefits for that year, and
for any portion of a year the total expenditures shall be
limited pro rata. The rate shall be fixed to apply as from the
date at which any insured persons first become eligible to
receive benefits under this Act until the thirty-first day of
March next succeeding, and the rate shall be revised semiannually thereafter to apply for the next succeeding period
of six months, until the thirty-first day of March next suc-
Page 182 *3
ceeding; and thereafter the rate shall be revised annually to
apply for the next succeeding year:
(d.)  Any combination or modification of the systems designated
in clauses (a) to (c):
Provided that, if either of the methods of remuneration set out in clause
(b) or clause (c) is used or any combination or modification thereof, from
the date at which section 4 becomes effective until the thirty-first day of
March, 1938, the Commission shall allocate from the Fund moneys for
the payment of physicians at the rate of not less than four dollars and fifty
cents per annum per insured person eligible to receive benefits.
Power to penalize physicians and others.
22. In addition to all other penalties prescribed by or under this Act, the
Commission may penalize any person, including any physician or pharmacist, and the manager of any hospital or laboratory, who fails to provide
services according to the standards prescribed by the Commission, and who
wilfully violates any provision of this Act or of the regulations, by debarring him either permanently or for a limited period, from all rights of serving
or of providing benefits for insured persons under this Act.
Reports.
23. The Commission may require from any person providing benefits
to insured persons such reports or information as it considers necessary.
PART IV.—Administration.
Health Insurance Commission.
24. For the purpose of administering and carrying out the provisions
of this Act, there is hereby constituted a Commission, which shall be known
as the "Health Insurance Commission" and shall be a corporation. The
Commission shall be composed of the Chairman and not more than four
other members, to be appointed by the Lieutenant-Governor in Council as
hereinafter provided. Two members shall constitute a quorum to transact
business. No vacancy shall impair the rights! of the remaining members to
exercise all of the powers of the Commission so long as two members remain.
In case of disagreement among the members in connection with any matter
over which the Commission has authority, the vote of the majority, as shown
in the Commission's record of proceedings, shall prevail and shall constitute
the decision of the Commission.
Chairman.
25. (1.) The Lieutenant-Governor in Council shall appoint the Chairman of the Commission, who shall hold office for a term of seven years, and
shall be eligible for reappointment for succeeding terms of office of the same
length. The Chairman may be removed from office by the Lieutenant-
Governor in Council at any time for cause. The Chairman shall devote his
full time to the service of the Commission and shall not hold any other
position of trust or profit. He shall receive a salary of not less than five
thousand dollars nor more than seven thousand five hundred dollars per
annum, as may be determined by the Lieutenant-Governor in Council.
The Chairman shall be the chief executive officer of the Commission, and,
as its representative, shall supervise and direct the administration and enforcement of this Act.
Other members.
(2.) The Lieutenant-Governor in Council shall appoint not less than
two and not more than four other persons as members of the Commission,
Page 18 5 each of whom shall hold office for a term of five years and shall be eligible
for reappointmentment for succeeding terms of office of the same length.
Any member may be removed from office by the Lieutenant-Governor in
Council at any time for cause. Each member appointed under this subsection
shall devote so much of his time as may be necessary to the service of the
Commission, and, subject to the provisions of subsection (3), shall receive
such remuneration from the Fund as may be determined from time to time
by the Lieutenant-Governor in Council, to an amount not to exceed two
thousand five hundred dollars per annum.
Vice-Chairman.
(3.) The Lieutenant-Governor in Council may at any time designate
as Vice-Chairman one of the members of the Commission appointed under
the provisions of subsection (2), who shall hold office until the expiration
of his tenure of office as a member of the Commission. The Vice-Chairman
shall assist the Chairman to supervise and direct the administration and
enforcement of this Act, shall devote his full time to the service of the
Commission, and shall receive in return therefor a salary not exceeding
three thousand five hundred dollars per annum in addition to such remuneration as he may receive as a member of the Commission pursuant to the
provisions of subsection ( 2).
Technical Advisory Council.
26. (1.) The Lieutenant-Governor in Council may appoint, for the
term of five years, not more than six persons to constitute a Technical
Advisory Council. The members to be appointed shall be persons equipped
by special training or experience to assist and advise the Commission, and
Ball include the Provincial Health Officer, the Chairman or some other
representative of the Workmen's Compensation Board, and a physician with
experience in private practice. At least one member of the Technical Advisory Council shall be a woman. Members shall be eligible for reappointment for like terms of five years. The members of the Technical Advisory
Council shall meet at the call of the Commission. It shahll be the duty of
the Technical Advisory Council to assist and advise the Commission with
respect to the establishment and administration of a system of health insurance.
(2.) The members of the Technical Advisory Council shall be paid
out of the Fund the amount of the travelling and other personal expenses
necessarily incurred by them in the discharge of their official duties; but
they shall not receive any remuneration for their services, except as may
be determined by the Commission with the approval of the Lieutenant-
Governor in Council.
Appointment of Director of Medical Services.
27. (1.) The Commission, subject to the approval of the Lieutenant-
Governor in Council, shall appoint and employ a physician as Director of
Medical Services, shall fix his salary, and shall determine his duties.
Appointment of other officers.
(2.) The Commission shall appoint and employ such other physicians,
officers, employees, and assistants as may be required for the administration
and enforcement of this Act, shall determine their duties, and, subject to
the approval of the Lieutenant-Governor in Council, shall fix their remuneration. All officers or employees receiving or disbursing moneys of the
Commission shall give bonds in amounts and with sureties to be approved
by the Commission.
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Duties and powers of the Commission.
28. The Commission shall administer this Act and shall have, in addition
to the duties imposed and powers granted elsewhere in this Act, the following duties and powers:—
(a.) Subject to the approval of the Lieutenant-Governor in Council, to make all such regulations, not inconsistent with the
provisions of this Act, as it may consider necessary to implement, to administer, and to enforce this Act:
(b.) To require that unless claims for compensation in connection
with medical services rendered to insured persons by physicians, pharmacists, hospitals, or other persons are filed within
a reasonable period of time after the performance of such
services, as may be determined by the Commission, the Commission shall not be liable to meet such claims for compensation:
(c.) To make such expenditures from the Fund as may be necessary to provide for the proper administration of this Act and
to provide benefits for the insured persons entitled thereto:
(d.) To appoint local committees to advise on and assist in the
administration of this Act in local districts:
(.?.) Subject to the approval of the Lieutenant-Governor in Council, to enter into agreements with the Government of the
Dominion or any body established by that Government to
act in its behalf to accept financial subventions to assist in
meeting the costs of the benefits for insured persons authorized under this Act:
(/.) Subject to the approval of the Lieutenant-Governor in Council, to enter into an agreement with the Government of the
Dominion to provide for the bringing within the scope of
this Act of employees of the Crown in right of the Dominion:
(g.) To investigate the problem of providing cash payments for
employees unable to work on account of sickness, and to
report its findings thereon to the Lieutenant-Governor in
Council:
(h.) To organize and administer voluntary hospital insurance
plans in co-operation with any hospitals that desire to participate:
(/'.) Generally to do all other things necessary to carry out the
full intent of this Act.
Publication of regulations and presentation to Legislative Assembly.
29. (1.) All regulations made by the Commission under the authority
of this Act shall be published in the Gazette, and each regulation shall have
effect from the date of publication, or from a later date specified in the
regulations, as if enacted in this Act; and all regulations shall be laid before
the Legislative Assembly as soon as may be after they are made.
Power to rescind regulations.
(2.) The Lieutenant-Governor in Council may by Order at any time
rescind the approval given to any regulation made by the Commission under
the authority of this Act, and may cause a notice of the Order to be published in the Gazette; and thereupon the regulation in respect of which
approval is rescinded shall cease to be in operation.
Page 185 Annual report.
30. (1.) The Commission shall, on or before the first day of March in
each yearsgmake a report to the Lieutemnt-Governor of its transactions
during the last preceding calendar year, which report shall contain such
particulars as the Lieutenant-Governor in Council may prescribe.
(2.) The report shall be forthwith laid before the Legislative Assembly
if it is then in session, or, if it is not then in session, within fifteen days after
the opening of the next session.
Powers of Commission in conducting inquiries.
31. (1.) The Commission shall have the like powers as the Supreme
Court for compelling the attendance of witnesses and of examining them
under oath, and for compelling the production and inspection of books,
papers, documents, and things in connection with any inquiry, hearing, or
proceeding of the Commission under this Act.
(2.) The Commission may cause depositions of witnesses residing
within or without the Province to be taken before any person appointed by
the Commission in a similar manner to that prescribed by the Rules of the
Supreme Court for the taking of like depositions in that Court before a
Commissioner.
Inquiries and powers of officers.
32. Any inquiry which the Commission considers necessary may be
made by any one of its members or by an officer of the Commission, or by
some other person appointed by the Commission to make the inquiry; and
the Commission may act upon his report as to the result of the inquiry, and
every such member, officer, or person appointed to make an inquiry shall,
for the purposes of the inquiry, have all the powers conferred upon the
Comrjpassion by section 31.
Divulging of official information.
33. No officer or employee of the Commission and no person authorized
to make an inquiry under this Part shall divulge or allow to be divulged,
except in the performance of his duties or under authority of the Commission, aiiy information obtained by him which has come to his knowledge in
making or in connection with an inquiry under this Act.
Employers' records.
34. Every employer within the scope of this Act shall keep a true and
accurate record of the full name and residential address of each of his
employees, the remuneration paid or payable to such employee, and the days
of employment for which such remuneration is payable to the employee,
and shall upon demand furnish the Commission with a statement of the
record verified under oath, and shall upon demand permit the inspection of
the record by the Commission or any of its officers at any time and as often
as may be necessary to verify the names or number of employees, the amounts
of remuneration paid or payable, and their days of employment.
Duty of employers to give information.
3 5. Every employer, including employers not otherwise subject to the
provisions of this Act, shall furnish to the Commission upon request all
information in his possession required by it to carry out the purposes and
provisions of this Act. The Commission may prescribe the time, manner,
and form in which the inforation shall be furnished and may require that the
information be verified under oats. The information shall be for the exclusive use of the Commission and shall not be made available to the public,
Page 186 !'*'
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except that it may be tabulated and published in statistical form if the
business affairs of individual employers are not thereby revealed.
Exclusive jurisdiction of Commission.
3 6. (1.) The Commission shall have exclusive jurisdiction to inquire
into, hear, and determine all matters and questions of fact and law arising
under this Act, and no proceedings by or before the Commission shall be
restrained by injunction, prohibition, or other process or proceeding in any
Court, or be removable by certiorari or otherwise into any Court.
(2.)   Notwithstanding the provisions of subsection (1), the Commission shall have full discretionary power at any time to reopen, rehear, and
redetermine any matter which has been dealt with by it.
Insured person to submit to examination.
37. (1.) Every insured person who applies for or is in receipt of any
benefits under this Act, if requested by the Commission, shall submit himself to medical examination at such time and place as it may direct. If the
insured person fails to submit himself to such examination, or obstructs the
same, his right to benefits may be suspended until the examination has taken
place.
Effect of refusal of medical treatment.
(2.) If, in the judgment of the Commission, an insured person persists
in such practices as tend to imperil or retard his recovery or refuses to submit to such medical treatment as is necessary to promote his recovery, the
Commission may, in its discretion, reduce or suspend the benefits to which
the insured person would otherwise be entitled.
Waiver of rights forbidden.
3 8. No agreement, by an insured person entitled to any of the benefits
provided by this Act, to waive any right or any of the benefits under this
Act shall be valid.
Reimbursement of Fund in certain cases.
39. If any benefits are paid for or furnished by the Commission under
this Act in the event of sickness or injury to any person who by reason of the
sickness or injury has a right or claim for compensation or medical services
against an employer or any other person for causing the sickness or injury
and for the damages resulting therefrom, or has a right or claim for compensation or medical services under the "Workmen's Compensation Act" or
any other Act, the Fund shall, to the extent of the benefits so paid for and
the cost of the benefits so furnished, be entitled to reimbursement out of
any sum or damages or allowance which that person receives by way of
compensation or payment for medical services or through suit or judgment
in settlement of his right or claim, and the Commission shall, to that extent,
be subrogated to the said right or claim as against such employer or other
person.
Power of Commission to take up personal claims.
40. (1.) If any person otherwise entitled to receive benefits provided
by this Act for sickness or injury has such right or claim as described in
section 39 and refuses or neglects to take the necessary action to enforce
his right or claim within such time as may be fixed by the Commission, it
shall be lawful for the Commission to take action or institute proceedings
at its own expense in the name and in behalf of the said person.
(2.) In case any judgment or award is granted in behalf of an insured
person in consequence of an action or proceeding under subsection (1), the
Commission shall be entitled to recover its reasonable costs and expenses in
Page 187 connection with such action or proceeding from said judgment or award
in addition to its claim for reimbursement against the insured person. But
the liability of the insured person to reimburse the Commission shall be
limited to the amount of money collected in respect of said judgment or
award.
Collection of moneys due to the Fund.
41. (1.) The payment of every sum of money which any employer or
person, other than the Crown, is required by this Act or the regulations or
by any agreement entered into under this Act to pay or forward to the
Commission may be enforced by action in any Court of competent jurisdiction in the name of the Commission, together with the costs of the
action, as for debt due by that employer or person to the Commission.
Filing of certificate as judgment.
(2.) Where default is made by any employer or person in the payment
or forwarding to the Commission of any sum of money referred to in subsection (1), or any part of that sum, the Commission may issue its certificate stating the sum so required to be paid or forwarded, the amount thereof
in default, and the name of the employer or person by whom it was required
to be paid or forwarded, and such certificate, or a copy of it certified by
any member of the Commission under the seal of the Commission to be a
true copy, may be filed with the Registrar of the Supreme or any County
Court, and when so filed shall become an order of that Court and may be
enforced as a judgment of the Court against that employer or person for
the amount stated in the certificate.
Rights of priority.
(3.) In the case of every amount payable to the Commission under
this Act by an employer other than the Crown, the Commission shall as
between itself and any other person be entitled to the same rights of priority
in respect of the payment of that amount as the Crown would have if that
amount were a debt due from that employer to the Crown.
Penalty for default in payment of moneys.
42. (1.) If any sum of money which any employer or person, other
than the Crown, is required by this Act or the regulations or by any agreement entered into under this Act to pay or forward to the Commission, or
any part of it, is not paid or forwarded at the time when it was so required
to be paid or forwarded, the defaulting employer or person shall be liable to
pay and shall pay to the Commission as a penalty for his default such a
percentage upon the sum in default as may be prescribed by the Commission,
and the penalty shall be added to the sum so in default and shall for all
purposes of this Act be deemed to become and be a part thereof.
Penalty for offences against Act.
(2.) Every person who in violation of this Act does any act which he
is prohibited from doing or refuses or neglects to perform or observe any
duty or obligation imposed on him shall be guilty of an offence against this
Act, and shall be liable, on summary conviction, to a fine of not less than
ten dollars and not more than five hundred dollars.
Penalties for breach of regulations.
(3.) The Commission may by the regulations provide fines, recoverable on summary conviction, for the enforcement of the regulations, but
in no case shall the fine exceed the sum of fifty dollars.
Page 188 'llftjr
Disposition of funds.
(4.)   All fines imposed under subsection (2)  or (3)  shall, when collected, be paid over to the Commission and shall form part of the Fund.
Notices and service.
43. Every notice or request which the Commission or any member, or
officer, or representative of the Commission is empowered or required to
give or make under the provisions of this Act or the regulations shall be in
writing, and may be served either personally or by mailing it by letter mail
to the address of the person to whom it is given or made. Where a notice or
request is mailed, service of the notice or request shall be deemed to be
effected at the time at which the letter containing it would be delivered in
the ordinary course of post.
PART V.—Commencement of Act.
Proclamation.
44. This Act shall come into operation on a day to be fixed by the
Lieutenant-Governor by his Proclamation.
■M
COMMENTS ON THE ACT
We would suggest that the following be read in conjunction with the
Act.
Preliminary Section
"Dependents." The fee paid is for each member of the family, not a
family payment. So, if $5 per annum were allowed per capita, a family of
5 would represent $25 per annum.
Women doctors have felt some anxiety over this Bill, but we think this
explanation will remove their fears:
"Physician" includes osteopaths, as registered under the Act.
Part I.
Section 4(1), "rate of remuneration." We had suggested that tias read
"total income from all sources," for obvious reasons. We are assured that
there are very few individuals who would obtain such income from other
sources as to matter and any attempt to segregate them would cost far more
than it is worth. The committee took this up with the Cabinet, and thinks
it best to accept this explanation.
Section 4, subsection (5).
The Committee registered its objections to this clause, and these were
ruled out.
We still object to this clause, as it omits many people who most genuinely need help—and we believe there is not sufficient reason for excluding
them.
Section 5. We object unreservedly to this clause. It is a completely
different clause to that presented in the original draft, where an income
limit of eighteen hundred dollars was laid down. This has been removed.
This would seem to throw the scheme wide open to everyone in the
Province, and we feel that it should meet with our unqualified and united
opposition. Section 11 does not adequately safeguard this clause against
abuse.
Part II.
Except for our reference to Section 2, we have no comments to make.
Page 189 Part III.
Section 16.
The Committee has considered this clause very carefully. Subject to the
possibility of regulations defining this more clearly and satisfactorily, we
would say that this is a thoroughly dangerous clause.
It would seem to menace very gravely the right of the patient to choose
his own doctor. It compels people in these categories either to go to a free
clinic, or pay their bills themselves; it groups tuberculosis, venereal disease
and nervous and mental diseases together in a way that shews a great lack
of information on these matters; and it leaves us with no clear understanding of where we stand.
Here again we must as an organised profession demand that this be
clearly and satisfactorily settled.
Section 17. Since the Commission is amply protected by 39 and 40, this
section, especially clause (b), is objectionable to us, unless some safeguards
be secured. Otherwise we may treat a patient for some time, and then discover we have no claim for payment.
Section 18. During this four weeks how are we to be paid?
Is the public to be notified that they are liable for this time?
Section 19. See above under Section 5.
Section 20. This clause gives very great powers to the Commission, and
the principle of free choice of doctor will be in danger, unless we are very
definite upon the subject.
Section 21. This is the crux of the whole Act. The Committee wishes
to make the following points: We recognise that in certain localities
a salaried system may be necessary and that even the capitation system may
be advisable in certain cases.
Otherwise, we believe as firmly as ever that the principle we should
follow and on which we should absolutely insist, is that specified fees should
be paid (and guaranteed) for specified work: that this should be done without restriction by any fixed pool, and that the medical profession as a whole
should insist firmly on these points. We may compromise on most of the
other points in this Bill, but this one is vital to us as a profession.
Section 22.   We feel that the organised medical profession should have
some say, as in Great Britain, in matters of discipline.
We understand that this does not mean that we are compelled to work
under the Act. These penalties apply only to those who consent to work
under it.
Part rv.
We note merely that while under the original drafts the medical profession was to be freely consulted as regards appointments, this is no longer
the case. The Committee feels that this is much the best way.
In conclusion, the points on which we have touched, while they do not
exhaust possible comment by any means, emphasize, as we believe, the need
for complete unity among ourselves. We must maintain a reasonable, fair,
even a generous attitude; but we must adhere to the fundamental principles
which have so often been laid down.
Page 190 HEALTH INSURANCE IN ENGLAND
•■ \v
ifivl
» 8
■,!!■
R. G. Leland, M.D.
Chicago
(Bureau of Medical Economics, American Medical Association)
(Continued from April issue)
Certainly even these claims indicate that inszirance has not gone far
toward "solving" the pressing problems of medical care. It did not bring
any significant contribution to preventive medicine or the care of the indigent? It has aggravated the overloading of hospitals and has forced on them
problems of administration and of financial support as pressing even as those
that have fallen on the hospitals in this country since 1930.
It has failed so completely to meet the demand for general medical care
that the British Medical Association is today as actively engaged in trying
to find new plans and methods of advance as is the organized medical profession in the United States. This is shown by the proposal for a general plan
for the medical care of the British people and other plans which it has
developed to add specialists' care, especially in the London area. This plan,
it should be noted, has brought strong criticism from the medical profession
because of the great reduction in fees to bring these services within the
paying ability of insured patients. It has been freely charged that standards
of specialization have been lowered in order to secure consultants who would
accept such fees.8
The almost complete absence of the use of laboratory service and diagnosis in panel practice has compelled the British Medical Association to
undertake the organization of a plan to provide such a service. The British
Medical Association has also organized several independent insurance plans
such as the British Provident Association and the Birmingham plan to meet
the needs of those outside the insurance scheme. In short, insurance, so far
from providing any answer to the problems of medical care, has left organized medicine with much the same problems as are to be found in the
United States.
The outstanding fact is that insurance has removed the possibility of a
choice among the ways of meeting such problems. If we are to judge by the
plans proposed by the British Medical Association and the public, there is
recognition, if not acceptance, of the inevitability, but not yet of the desirability of the complete socialization of medicine in Great Britain.
The situation may offer an explanation why nearly all of the statements
of the representatives of organized medicine in Great Britain are favourable
to insurance. The British Medical Association is now so deeply involved in
the scheme and has given such hostages to political fortune in connection
with its administration that it is pledged to its defense. Before accepting the
statement which is so frequently made that the British physicians are practically unanimous in favour of insurance, it is well to consider that every
physician has a chance to vote his approval in the most effective way by
signifying his willingness to practice under panel conditions. Judged by this
test, only 44 per cent of British physicians have so registered their willingness. The remaining 56 per cent apparently are not willing to accept the
conditions of the scheme. Furthermore, of the 44 per cent that are registered
as panel practitioners there are many who still depend primarily on private
practice but who only enter their names on the panel because of local
situations. Much is made of the claim that insurance has increased the income
Page 191 of the panel physician. We can well believe this when we remember the conditions that preceded insurance. It has undoubtedly raised many physicians
from a "starvation" to a "subsistence" level. The average income of a panel
physician from insurance is about $2000 annually. Approximately $1000 of
this must be spent in maintaining this practice. This does not indicate a
very high level of payment, even though we remember that panel practice
is often incidental and that the main dependence is on private patients.
The real reason why organized medicine in Great Britain and the great
percentage of the population now express a more or less approval of insurance is because it is an accomplished fact. Apparently there is no movement
in England to abolish insurance. Such a movement would be futile. The
nation has now progressed too far along this road. There is no turning back.
The United States is not now where England stood in 1911. It is in a far
more favourable position to choose the road which it will follow. It has
developed methods of meeting the problems of medical care that are far in
advance of those existing in England at that time.
This is the really important question, hypothetic though it may be! If
England were back in 1911 in the situation which now exists in the United
States, would it choose the road of insurance? On this point an oft quoted
and discussed statement of Sir Henry Brackenbury may be in point. He
began a recent address on "What Is Wrong with National Health Insurance?" with these sentences:
By this address I want to be provocative of thought. My title is not a statement, but
a question; and though relative brevity must almost always lead to some appearance of
dogmatism, I do not want to be dogmatic but interrogatory. First, I want to recall two
passages from the Memorandum of Evidence submitted on behalf of the British Medical
Association to the Royal Commission on National Health Insurance.
"The measure of success which has attended the experiment of providing medical
benefit under the National Health Insurance Acts system has been sufficient to justify the
profession in uniting to ensure the continuance and improvement of an insurance system.
"The organization of a National Health Insurance scheme is not necessarily, or even
probably, the best means of utilizing limited resources for the promotion of national health.
It is more than likely that there are a number of other directions in which, sevferally or
collectively, a corresponding expenditure would produce an even more satisfactory return."
Those statements were made more than eight years ago. There can be no doubt, however,
that contradictory as some may think them, they are both regarded as true by the great
majority of the medical profession today.
(Concluded in June issue)
"Absolute Accuracy"
In filling the eye physician's prescription, nothing short
of absolute precision will satisfy us.
We take a pride in maintaining
Guild standards to the utmost.
OPTICAL CO. LTD.
Dispensing Opticians
430 Birks Bldg., Vancouver, B. C.
Page 192 7 DAYS
all - inclusive
SPA
RECONDITIONING
COURSE
Includes  room
■with bath and
three  delicious
meals daily.
40
Same  course
after June
1st, $50.
Two hours' drive from Vancouver
over good roads; by C.P.R., C.N.R.
or daily Gray Line Busses.
Bubbling
Hot
Potash and
Sulphur
Springs—
Nature's
health-
giving
•waters.
Ti
*IRED professional men find the beautiful Harrison
Hot Springs Hotel a rendezvous for rest and complete relaxation. Only a few feet above sea level, yet
enveloped in invigorating high mountain air; a paradise of glorious scenery, mountain and lake. Rates are
moderate, accommodation is luxurious—a few days
revitalizes and eliminates that tired feeling.
Telephone Trinity 2201 for complete information.
Write for illustrated book, "Seven Steps
to Vibrant Health."
HARRISON HOT SPRINGS Hotel
HARRISON, BRITISH COLUMBIA
FIFTEENTH ANNUAL MEETING
PACIFIC NORTHWEST!
MEDICAL  ASSOCIATION
PORTLAND, OREGON — HOTEL MULTNOMAH
JULY 8, 9, 10, 11, 1936
GUEST SPEAKERS:
Ray M. Balyeat, M.A., M.D.
Russell  L. Cecil, A.B., M.D.,
Sc.D.
Carl Henry Davis, A.B., M.D.
D. J. Davis, B.S., M.D., Ph.D.
Paul John  Hanzlik, Ph.C, A.B.,
A.M., M.D.
Alexis F. Hartmann, B.S., M.S.,
M.D.
Chevalier Jackson, D.Sc, M.D.,
LL.D.
Walter J. Meek, A.B., Ph.D.
Harry E. Mock, B.S., M.D., Sc.D.
Roy D. McClure, M.D.
Lewis J. Pollock, M.D.
N.B.—Additional speaker in Medicine to be announced later.
This will be one of the finest meeting's in. the history of the Association.
-Plan to attend.
For Memberships Apply to:
DR. JOHN C. ADAMS DR. JAMES M. BOWERS
Medical-Dental Bldg., 530 Stimson Bldg.,
Portland, Oregon. Seattle, Washington.
or
DR. C. W. COUNTRYMkN, Secretary-Treasurer,
262 Paulson M. & D. Building, Spokane, Washington. TWO DECADES OF SERVICE
TO THE MEDICAL PROFESSION
Progressive Gynecologists and Physicians in
general have endorsed PON-TAM-PONS for the
past twenty years as an easy, safe and thorough
method of vaginal and uterine medication. It
combines the medicinal function of a vaginal suppository with the mechanical support offered by
a correctly shaped tampon, ensuring the continued
application of the medicament to the diseased
areas and at the same time furnishing the necessary support.
m
ill! !
■Samples   will  be
gladly   furnished
to   physicians  addressing us on their
own stationery.
The various treatments to which the tampon is
adaptable will be at once apparent to the physician, but lacerations, leucorrhoea, gonorrhoea,
prolapse, post-operative and post-confinement
treatment, and uterine hemorrhage are some of
the conditions in which PON-TAM-PONS offer
new and most effective treatment. There are many
unique points of advantage in treatment by PON-
TAM-PONS.
PON-TAM-PONS are packed in six tampons to a
box and are made to the following medication:
A — ICHTHYOL COMPOUND, Glycerin and Boro-Glyceride
50%, Ichthyol 2.5%. Resublimed Iodine .14%, Carbolic
Acid (absolute Phenol) .5%, Powdered Hydrastis 1%.
ICHTHYOL 10%, Glycerin and Boro-Glyceride 50%.
Gl
ycenn
C — PROTARGOL AND ICHTHYOL (Each 2cr
and Boro-Glyceride 50%.
E — GLYCEROLE OF TANNIN 50%.
F —ICHTHYOL   COMPOUND  WITH  SILVER  IODIDE.
Glycerin and Boro-Glyceride 50%. Ichthyol 2.5%, Iodine
14%, Phenol .5%, Powdered Hydrastis 1%, Silver Iodide
made soluble by Potassium Iodide)  1%.
G — GLYCERIN   AND   BORO-GLYCERIDE.   Glycerin  and
Boro-Glyceride 50%, Resublimed Iodine 25%.
H—-PLAIN GLYCERIN Gelatin base.
CANADA POND-TAMPON CO.
Sole Manufacturers in Canada
Western Distributors Ltd., Wholesale Distributors,
Vancouver, B. C.
PON-TAM-PONS may be obtained through all wholesale and
retail druggists in Canada. .
Please -write for further information* IE!
M
_l  s   »i:
I? ¥ g H I 7 Q
Prompt relief of the distressing symptoms which often accompany
pyelitis may be obtained by the oral administration of Pyridium.
Shortening of the duration of treatment has been reported in
many cases. Pyridium is non-toxic and non-irritative in therapeutic
doses.   Pyridium   solution   for   kidney   lavage   may   be   employed
;
effectively with the oral administration of the tablets.
TRADE
IP ¥ @ 3 _» 0 5J
MARK
l m,
LITERATURE   WILL   BE   MAILED   ON   REQUEST
Merck & Co. Ltd., Manufacturing Chemists, Montreal, Que.    A PRESCRIPTION SERVICE . . .
Conducted in accord with the ethics of the Medical
Profession and maintained to the standard suggested by
our slogan:
Pharmaceutical Excellence
AAcG!ll 6 Ofmo ■
LIMITED v-'
FORT STREET (opp. Times)      Phone Garden 1196     VICTORIA, B. C.
Nitntt $c aMjttmj-fltt
ancouver,
NOVARSENOBENZOL BILLON
Acknowledged throughout the world as standard
arsenical spirochaeticide.
• Its great value was clearly demonstrated during the Great War
where its use among the Allied Armies checked the menace of
an epidemic of syphilis among the soldiers. Many Canadian
practitioners can trace back their unfaltering attachment to
Novarsenobenzol Billon to these days.
• Since then, Novarsenobenzol Billon has consistently retained
the preference of Canadian physicians and specialists. It is now
employed in a large number of hospitals and Governmental
controlled V. D. Clinics.  It!    '
STEVENS' SAFETY PACKAGE
STERILE GAUZE
is a handy, convenient, clean commodity for the bag or the office. Supplied
in one yard, five yards and twenty-five yard packages.
ESTABLISHED  NEARLY A
~ fcCENTURYyfi
B. C. STEVENS CO.
Phone Seymour 69S 730 Richards St., Vancouver, B. C.
S. BOWELL & SON
DISTINCTIVE FUNERAL
SERVICE
Phone 993
66 SIXTH STREET
NEW WESTMINSTER, B. C.
£|p}|eaks:the vicic^ cijrcle of perverted
menstrual function in cases of amenorrhea,
tardy periods (non:p^^3ogical) and dysmenorrhea. Affords remarkable sytnptomatic
relief by stimulating theS^inervation of the
*pj£4?rus and stabilizinglSrhe tone of its
muscul_t-j||^C6ntrols: pe utero-ovariari
circulation and thereby;encourages a    ,
norrtiftlfmenstruai cycle,
^      _-^^-«^^l8^:?^l^^^__^^l^^;^  •*
• MARTIN H. SMITH COMPANY
ISO LftFATITTi SHUT, NiW TOM. N. Y.
Full formula and descriptive
literature on request
Dosage: 1 to 2 capsules
3 or 4 times daily. Supplied
in packages of 20.
Ethical protective mark MHS
embossed on inside of each
capsule, visible only when capsule  is  cut in  half  at seam.
'^^^^^^^^^^^^^^^^^^^^^^m
11
n ■ -yy 'W   y ■^ ^ ■
' V '» W   -" «§■'  W  V ▼ 'V
PHYSIOTHERAPY
ANTIPHLOGISTINE is compatible with all
__ other forms of medication and in physiotherapy it is a very satisfactory adjuvant.
Following treatment by X-rays, diathermy, ultraviolet rays, etc., it has a soothing, decongestive
and absorptive action.
Erythematous, erosive, edematous and painful
conditions are benefited by its use and regeneration of circulatory nutrition is promoted.
In Dermatological and Rheumatic
Affections
and in those conditions requiring hyperthermic
temperatures, while Antiphlogistine itself is an
active thermogenous agent, when used in conjunction with physiotherapeutic measures, it
serves to potentiate their effects.
Sample and literature sent on request.
ANTIPHLOGISTINE
Made in Canada
The^Denver Chemical Mfg. Co.
153 Lagauchetiere St. W.
MONTREAL Now Ready
\m
of
jP|||i^O L E U M
K__fS_^_yK_
25 soluble gelatin
capsules in a box
advertised to
e public
IN PREGNANCY and LOW-CALORIE DIETS
and wherever vitamins A and D are required with
minimum added calories
RESTRICTED diet regimens, as for
the obese, know no season for vita*
min therapy. Because of the frequent
drain on the mother's stores and the
added requirement of the fetus, the need
for vitamins A and D is increased during
pregnancy. Yet, it is in just such cases
that there may be an aversion or intolerance to fats. In the obese, who studiously avoid butter, cream and other
good sources of vitamin A, the deficiency should be made up. This can be
done in a convenient and highly acceptable manner by prescribing Mead-
Capsules of Oleum Percomorphum,
which combine a high potency of both
vitamins A and D. Each 10-drop capsule
supplies natural vitamins in amounts
not less than 13,300 A units and 1,850
D units (U.S.P.). Every capsule represents more than 5 teaspoonfuls of cod
liver oil* in vitamins A and D. These
vitamins, moreover, are in the same
ratio as in cod liver oil. *
*U.S.P. XI Minimum Standard
For physicians who prefer Mead's Viosterol in Halibut Liver
Oil, 3-minim capsules containing not less than 8,500 vitamin
A units and 1,700 vitamin D units (U. S. P.) are? available.
MEAD JOHNSON & CO. OF CANADA, LTD., Belleville, Onf.
Please enclose professional card when requesting samples of Mead Johnson products to cooperate In preventing their reaching unauthorized parsons FINE DAYS ARE HERE AGAIN
—but no holidays here I
It's our privilege to be ready when you phone—night
or day, Sundays, holidays!
It is our regular day by day patronage that makes our
responsible emergency service possible.
OPEN
ALL
NIGHT
GEORGIA PHARMACY
<&tx&n $c Hf arota %tb 

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