The Check-Off: The First Mandatory Healthcare Insurance System in Canada: Introduction

by Dr. Chryssa McAlister

The Cape Breton Coal Miners received comprehensive healthcare through a mandatory insurance plan decades before the rest of Canadians. The "check-off" was a healthcare insurance system where deductions were made from the miners' wages for a subscription to physician services, medications and hospital care. The check-off remained in the Cape Breton mining towns until 1969, when it was replaced by the national plan of medical care insurance in Nova Scotia, Medicare, administered by Maritime Medical Care.

This research was completed for an elective project in the medical humanities and a documentary for CBC radio. A literature review of the history of the check-off system for healthcare services was performed at the Beaton Institute of the University College of Cape Breton, Sydney NS and the Killiam Library at Dalhousie University, Halifax, NS. Most Information was attained through recorded personal interviews with participants in the check-off system, including patients, doctors, hospital administrators, politicians, and union organizers. Interviews were recorded with the help of CBC Radio and included in a CBC documentary presented on Cape Breton Information Morning.

The Radio Documentary (Interviews with miners and doctors - 17 min.) was aired in the summer of 2003 on the CBC program, Cape Breton Information Morning. Just over 17 minutes long, it consists of the primary interviews and a brief overview of the system and its impact on society.

I would like to acknowledge the following persons who supported and guided me in this research: Dr. Twohig, Mrs. Kathy Large, Mr. Don Munro, Dr. Jock Murray, Dr. V. McAlister and Mr. Tim Ruggles.

Read: The Check-Off: A precursor of medicare in Canada? - Article by Dr. Chryssa McAlister and Dr. Peter Twohig. CMAJ. December 6, 2005; 173 (12).

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