improve their standard of living. Part,icipants (together these two nccouiit for more than half learned to prepare a family budget, to compare the national population). is now preparing values, prices, and credit when shopping, and to launch a program that, will probably meet to use group effort to combat financial ills. Use Federal requirements and may become operative of the credit, union as the alternative source of by mid-1970. already has a voluntary credit was st,ressed. scheme, but it does not yet, satisfy These programs, which were conducted in 1967, the Federal crit,eria for universality. were sponsored by the Universit,y of South Although the Federal Government contributes Dakota. The Project Moneywise task force pre- about. half the participating ’ medical sented an B-day consumer education program at insurance costs, the exact level is established by a Standing Rock, North Dakota, in May 1968, and it formula designed to give relatively more assist- is hoped that in the future more universities will ance to economically disadvantaged Provinces. sponsor similar training for residents of reserva- A national per capita cost is first determined by tions in their areas. averaging medical insurance expenses of all participating Provinces. The individual then receives half this amount for each resident who benefits from the program. The effect of the Social Security Abroad formula is to reimburse a province with low medical costs for more than 50 percent of its ex- penditures for medical insurance. The method of financing each participating EXPANSION OF ’S * Province’s share of the cost varies widely. has a compulsory premium set at a On hpril 1, 1969, Newfoundland, , level designed to cover the entire Provincial share and Manitoba joined Canada’s national program of the cost. also depends to a for health insurance, bringing the total number of certain degree on compulsory premiums, but, they Provinces now participating to five. When the are set, at a much lower level. Since April 1968, program first went, into effect last July, only Saskatchewan has also been collecting utilization Saskatchewan and I3ritish Columbia had estab- fees to discourage overuse of medical facilities. lished medical insurance plans that, qualified. has a voluntary premium plan, Although some of the other Provinces also had and Newfomidland and Nova Scotia rely on gen- comprehensive medical care programs, they were eral revenue financing. not structured t,o satisfy all of the Federal Gov- In December, Canada’s Minister of Finance ernment’s requirements. To qualify for Federal stated that expansion of the national medical in- funds, a Provincial plan essentially had to be surance program would help to curb the rising universal, comprehensive, portable, and publicly rate of medical costs. He noted that, in Saskatche- administered. “Portability” referred to measures wan (which has had a universal medical insurance for safeguarding cont,inuous protection for per- scheme since 1962) administrative costs represent sons moving between Provinces or temporarily about 6 percent of total medical costs; at the same absent, from their own Provinces. A Province’s time, according to the Hall Royal Commission,1 plan was considered to be universal if it furnished private insurance groups generally collected, on insured services to 90 percent of its insurable a national basis, $1.3’7 for every $1.00 expended in residents initially and 95 percent subsequently. benefits. Furthermore, physicians’ fees in Two other Provinces, and Saskatchewan rose only 4.5 percent per year be- , have recently expressed their intention tween 1963 and 1967, in contrast to a rise of 8 per- to participate in the national medical insurance cent a year in the rest of the country. program during this calendar year. The three The Minister of Finance also suggested that, remaining Provinces are (Continued on page 58) and the two most populous, Quebec and Ontario 1 The Hall Commission was appointed in 1961 to study *Prepared by Joseph Simanis, International Staff, Of- medical needs in Canada. It submitted its final reports fice of Research and Statistics. in 1964 and 1965.

36 SOCIAL SECURITY TABLE M-27.-Gross national product and personal income, by type, 1940-69 [Amounts in hillions. Before 1960, data we for the 48 States and the District of Columbia, except where otherwise noted. Beginning 1960. inclndos Alaska and Hawaii]

Personal income - - Social insurance and Public assistance Qross Less: Period national related payments 1 payments * Wage and I personal product Total salary dis- Other contribu- 1Jursements 1 Percent of Percent of income 4 tiooo;3 Amount P$c;.cel Amount ‘I;c;zel insurance 5 .------1940-.--...---.------. wQ.7 $78.2 L $1.7 2.1 1 $26.4 SO.7 1945------..--.-..-.------211.9 371.1 E? “::1 52.1 2.3 1954 __---- _ ------__- _ 227. f , 146:7 i:! :2 l.C I 74.7 1955 ______E.0” 310.6 , 211.3 12.7 4:1 89.7 :.i lQ60 ____------_------503:7 4Ol.C I 270.8 23.3 5.8 :: 112.9 9:s 1981-----.------.-.------520.1 416. E 278.1 26.8 3.4 118.2 9.6 1862 ______560.3 442.6 , ‘296.1 27.8 :i 125.6 10.3 1963------.-.-----.------590.6 465.5 311.1 33:: 133.2 11.8 1964--.--.-.-._-_.__------632.4 497.5 333.7 2:: :: 142.0 12.5 1965------.------538.9 , 33.1 2: 13.4 1966------t-z 586.3 2: 36.3 1: :z*: 17.8 1~7---..-----.-.------789: 7 628.8 423: 4 :4 .8 177:Q 20.4 lsgs ______-__-- _____. 860.8 685.8 463.6 28” 5:6 .8 180.9 22.9

April ___. ______. 672.6 453.2 48.6 188.0 22.6 May. ______. _ __ . ::; 2: :: 189.3 22.3 June--...... --- 852.9 Ef 8E :z 7.2 515 180.9 22.9 Julv ______.______-... _..-_.__ _ __.__ 689:2 465:4 :i 192.1 23.1 August ___._..__ :.-I __...... 694.1 468.7 :,gfi ;:1 ::; 193.1 September ______..__ 871.0 699.7 472.8 49.9 5.8 :: 194.5 2: October...... ----. __ 703.2 474.9 50.3 :::: 5.9 1Q5.5 23:4 November ___.....______.- 708.0 475.9 6.0 :s” 196.1 23.5 December __.__..__.______887.4 713.5 483.3 it: 2: 5.9 .8 187.8 23.5 1969

JEUlU*ry __..._.______----.___.___ 716.1 486.5 51.5 7.2 5.9 .8 197.6 25.4 February ______-_-.--_ ._--.______-_ 721.4 490.9 52.0 25.5 MtUCh- _.__..... 903.4 727.7 495.7 52.2 ::; 6”:: :i :2:; 25.6 April ___. _ _ _. 730.6 497.4 52.6 7.2 6.2 .8 200.0 25.7 - - 1 Includes payments in kind; includes pay of Federal civilian and military value of surplus food stamps. Excludes payments made in behalf of recip- personnel in all areas. Excludes earnings under work-relief programs in ients to suppliers of medical care (vendor payments). effect during 1935-43. 4 Includes proprietors’ income, dividends. personal interest, and rental 2 Includes government transfer payments to beneficiaries under OASDHI, income; other transfer payments not enumerated in footnotes 2 and 3 (such railroad retirement! public employee retirement, unemployment insurance, as Government life insurance payments, World War bonus payments, and veterans’ pensloos and compensation programs; cash and medical pay- mustering-out pay and terminal-leave benefits to discharged servicemen, merits under workmen’s compensation and temporary disability insurance: subsistence allowances to veterans at school): and employer contributions to and court-awarded benefits for work injuries sustained by railroad, maritime. private pension and funds and other labor income (except compensa- and other workers under Federal employer liability acts. tion for injuries). 3 Includes government transfer payments to recipients of direct relief under 3 Includes life insurance premium payments for veterans. programs of old-age assistance. aid to families with dependent children. aid Source: Department of Commerce, Office of Business Economics. Data to the blind, aid to,the permanently and totally disabled, and general assist- awe: includes, during 1935-43, earmngs under work-relief programs rind the regrouped to highlight items ofspecial interest to the social secnrity,progrsm.

SOCIAL SECURITY ABROAD would then be compensated for the increased (Continued from page 36) financial burden by receiving a share of the Fed- efforts to hold down medical costs would be eral Government’s general tax revenue. The Minister of Finance suggested that the change facilitated if changes in the method of financing would permit closer supervision of hospitals by hospitalization insurance were adopted. Canada’s the provinces and would thus result in greater hospital insurance-in existence since 1958-is economies. Further action in this direction is, presently administered on a Federal-Provincial unlikely, however, until current Federal- cost-sharing basis similar to that for medical in- Provincial discussions resolve the general ques- surance. Under the neti proposals it would be tion of revenue-sharing and the broader, but re- turned over completely to the Provinces. They lated, issue of constitutional reform.

58 SOCIAL SECURITY

t