Health - Six Years' Experience of Prepaid Medical Care for the Employees of the Hollinger Mine (T .P. 1752, Mining Tech., Sept. 1944)

In 1937 the employees of the Hollinger Consolidated Gold Mines Ltd.. at Timmins. Ont., Canada, approached organized medicine for a plan to provide themselves and their families with a complete medical service including hospitalization. This approach was made because of two conditions: (1) the necessity for some organization whereby contributions could be made in instalments to offset the sudden and large expense connected with illness for which the average employee is not prepared, and (2) the need for a more cohesive quality of service to replace a contract practice then in vogue, which did not take care of the employee's family or dependents. In different parts of the United States and Canada similar plans were in force, not only for employed groups but for numbers of people in circumscribed areas. In Europe different countries had adopted various forms of health insurance plans. It then was no surprise that these employees as a group should ask for some similar plan. With the cooperation of the management, a plan was instituted. The plan has one object only—the provision of medical services, including the accessory services such as hospitaliza-tion, X-rays, nursing, and necessary drugs and medicines. It is not concerned with cash benefits, sickness and accident payments, or any form of monetary return as the result of illness, but is simply an organization to provide medical services and pay for them from a central fund. It is a nonprofit organization and the only shareholders are the employees and their families who contribute and who in turn receive services. The Hollinger plan is limited to the employees of the Hollinger mine, who live in Timmins and the immediate vicinity. At first, the membership was voluntary. In the third year, it was made a condition of employment, with the proviso that at the end of any Association financial year an employee may withdraw if he wishes to do so. After withdrawal, he cannot again become a member until the end of the next Association year, and then only by the payment of the back dues. This step was taken to ensure continuity, and to prevent employees from withdrawing when well and reentering when faced with impending illness or operations. The employee himself is subject to medical examination on application for employment, and if accepted is subject to further examination by a specialist in chest diseases under the Workmen's Compensation Board of Ontario. Thus it is possible to exclude those who have heart disease, tuberculosis, or other disabling conditions when first employed. Wives and families of employees are not subject to medical examination but other dependents of an employee—mother, father, or other relative—who are declared by the employee to be wholly dependent upon him must be examined. The employee