Canadian Medical Association Journal 1996; 154: 80
Hall's landmark study was launched June 20, 1961, by his longtime friend, Prime Minister John Diefenbaker. Although the final recommendations on medical insurance angered many physicians, the study was in fact initiated by the CMA.
In 1960, CMA General Secretary Arthur Kelly wrote the prime minister "to request that there be established a Royal Commission . . . for the purpose of assessing the health needs and resources of Canada with a view to recommending methods of ensuring the highest standard of health care for all Canadians."
A CMAJ report on Kelly's correspondence (Dec. 24, 1960) noted: "It has become evident that there exists in Canada a considerable degree of public and political interest in health insurance as a matter of public policy." However, there was concern that such a popular idea would become a political tool and that parties would present "a variety of proposals, each endeavouring to outdo the others . . . to capture popular favour." The report went on: "We are particularly conscious that the heat of an election campaign does not provide the best atmosphere for dispassionate consideration of the subject of health insurance."
Physicians, CMAJ said, would recognize the association's request for a royal commission as a step that would remove "the consideration of health and health insurance from the area of political controversy and subject it to the study it deserves."
Diefenbaker responded the following June by announcing the creation of a comprehensive and independent study to look at Canada's health care needs and resources. The study, the CMA commented, "may have the most profound consequences on future developments in Canada."
When Hall's report was tabled in the Commons in June 1964, the CMA found that many of its recommendations related to health care personnel and facilities had been adopted. In the area of medical-services insurance, however, "the commission's recommendations were completely at variance with [CMA] policy." Concerns were related to compulsory insurance coverage for self-supporting citizens, individual freedom for physicians, the failure to provide an opting-out provision, patient choice of insurance coverage, mandatory fee schedules and single-source funding for medical, hospital and pharmaceutical benefits.
The CMA's concerns fell on deaf ears, however, and in 1966 the federal government introduced and passed Bill C-227, the Medical Care Act, and virtually ignored physicians' representations. A Dec. 17, 1966, report in CMAJ remarked with resignation that "[the bill] contains many sections with which we strongly disagree and we believe that these will cause problems in the future. However, as physicians we will accept the role of trying to provide the best quality medical services for our patients within the limitations which this Act will impose."
Decades later, Hall remained immensely proud of the medical system his report initiated. A Nov. 14 tribute in the Globe and Mail recalled a 1990 speech Hall gave in Vancouver: "I would give it an A-plus. . . . We have the best medical system in the world." At the time he urged physicians and governments to find ways to solve their conflicts: "Doctors cannot be a law unto themselves, nor should the state have the right to conscript their services."
He and his wife, the former Isabel Parker of Sydney, NS, had two children: Marian, a lawyer who became a judge with the Saskatchewan Court of Queen's Bench, and John, who was chief of orthopedics at Toronto's Hospital for Sick Children before leaving Canada to practise in the US.
In recent years Hall lived quietly in Saskatoon. A companion of the Order of Canada, he also received an honorary medical degree from the University of Ottawa -- the only one of its kind ever awarded in Canada.