Building on its previous discussions at the Medical Services Conferences in the 1920s, in 1931 the Canadian Medical Association (CMA) created a Committee on Economics to examine the concept of health insurance. Chaired by Dr. Harvey Smith of Winnipeg, the immediate past president of the British and Canadian medical associations, the committee represented concerned doctors from across Canada. Dr. A. Grant Fleming of McGill University and the Montréal Anti-Tuberculosis League served as the secretary and prepared the report, which used the models developed in British Columbia and Alberta as the basis for a federal–provincial shared-cost health insurance system that was presented to CMA members at their annual meeting in Calgary in 1934. Although the CMA approved the plan in principle, it had to be reviewed by all the provincial medical associations prior to being sanctioned at the joint meeting of the American Medical Association and the CMA in Atlantic City in 1935. With some minor changes, the principles outlined in 1934 would remain the foundation of the CMA’s position on health insurance until 1949.