In 1966, the government of Quebec mandated Mr. Castonguay and Mr. Nepveu to prepare a report for the implementation of a universal healthcare system. In 1969, the Commission of Inquiry on Health and Social Welfare, also known as the Castonguay-Nepveu Commission, recommended the creation of the Quebec Health Insurance Plan (Régie de l'assurance-maladie du Québec) and submitted, in 1970, a report that underlies the existing healthcare system in Quebec (Government of Quebec 1970). The key recommendations of this report were the creation of three university networks (three faculties of medicine in Quebec at the time) with distinct levels of healthcare services: primary (community), secondary (hospital) and tertiary (specialized services).

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