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A comparative review of the medical services programme for public assistance recipients in British Columbia Mann, Aileen Elizabeth

Abstract

This thesis has reviewed the medical care programme for public assistance recipients in British Columbia. It has been concerned with eligibility qualifications, the extent of services provided, and the administration and financing of these services. As background material, recent developments in social assistance medical care in Canada were summarized. Particular attention was given to an analysis of the Saskatchewan programme, as its philosophy of public assistance is similar to that of British Columbia. Eligibility for medical services is not a complex subject in British Columbia because it simply extends to all categories of public assistance. The same may be said of the actual provision of services. British Columbia does not have the usual administrative tangles usually surrounding the kinds of services offered because of the fact that it has chosen to provide comprehensive care. The administration and financing of the programme offers plenty of material for discussion by the student of public administration. It is evident that the provincial role is predominant, as is true of many aspects of provincial-municipal relations in British Columbia. The contribution of the municipalities is largely confined to a share in the financing of the scheme, and this is not large. The Director of the Medical Services Division carries administrative responsibility for the programme, but the Canadian Medical Association (B.C. Division) through its Social Assistance Medical Service is responsible for remuneration to the individual physician from a pooled fund provided by the provincial government. The administration of public funds by a private body is a much-discussed issue in the extension of public medical care, but it suffices here to state that the plan seems to be working satisfactorily in British Columbia. Probably the distinctive contribution of the programme is the integration of the physician and the social worker in the planning of the physical and social rehabilitation of the individual. The relatively comprehensive nature of services, both medical and of a social work nature, contribute to the integration. The extension of medical care is now a lively issue in Canada, and has become a focal point in federal-provincial relations. British Columbia has prepared itself for an inclusive programme through the introduction of hospital insurance, but its pioneering in medical care for the needy may also be of aid in the planning of the larger programme which must inevitably come.

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