Contents: Report of the Royal Commission on National Health Insurance

MAJORITY REPORT. 
Approved Societies, App. XCII, 111-112; Q. 22,049, 22,052; 
Standing Joint Committee of Industrial Women’s Organisations, 
Q. 28,151), that there is no logical reason why the rate of benefit 
should be reduced after 26 weeks of illness, as the need for 
financial assistance would ordinarily become greater with the 
prolongation of illness; and it was urged upon us that in order 
to mitigate to some extent the distress which must often arise 
by reason of the scanty provision afforded by the present disable- 
ment benefit, the rate of that benefit should be increased. This 
point of view commands respect, but the proposal to which it 
leads must be examined in the light of experience. On this it 
has to be said that the reduction of the rate of benefit after 26 
weeks is not a novel feature of sickness insurance introduced for 
the first time by the National Health Insurance Act. While the 
period after which it is made is not invariably 26 weeks, such 
a reduction is universal in the practice of Friendly Societies and 
of those Trade Unions providing sickness benefit. The necessity 
for it has arisen on financial and administrative grounds, and we 
are advised that in the few cases in which in the past Societies 
have attempted to dispense with it, the hard facts of experience 
have enforced its adoption upon them. The present system, 
so far from having gone unquestioned, was the subject of attack, 
on the very ground submitted by our witnesses, so long ago as 
1835, when Ansell dealt with it in his treatise on Friendly Socie- 
ties. The writer in question was an actuary of eminence in his 
day, and his views might have been expected to obtain a con- 
siderable degree of acceptance. In this respect they either failed 
to appeal, against the teachings of experience, or if put into 
practice, were discarded when their impracticability was 
demonstrated. 
318. We cannot ourselves assume the responsibility of 
advising that the lessons of experience on this important subject 
should be disregarded however reasonable in logic is the plea 
submitted to us. We have nevertheless thought it proper to 
refer the matter to the Actuarial Committee. It will be 
seen from their Report that after making allowance for 
the recent experience as to the cost of disablement benefit 
and for a further margin of 20 per cent. to meet the strong 
probability, dictated by the practical experience to which we have 
referred above, that an increase in the rate of disablement 
benefit would involve a greater frequency and a greater duration 
of claims, the margin in the present contribution would allow 
for an increase of 2s. 6d. a week in the case of men but only of 
9d. a week in the case of women. Here again we are faced 
with the difficulty that within the limits of the present contribu- 
tions, men would be given a substantially better treatment than 
women. We do not think that a mere addition of 9d. to the 
present rate of 7s. 6d. is worth serious consideration. Beyond 
this, as we have indicated, we are very much impressed with
	        
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