Report of the Royal Commission on National Health Insurance

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Monograph

Identifikator:: 1740277147

URN:: urn:nbn:de:zbw-retromon-132094

Document type:: Monograph

Title:: Report of the Royal Commission on National Health Insurance

Place of publication:: London

Publisher:: Stationery Office

Year of publication:: 1926

Scope:: XII, 394 S.

Digitisation:: 2020

Collection:: Economics Books

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Document type:: Monograph

Structure type:: Chapter

Title:: Chapter VIII. The approved society system

Collection:: Economics Books

MAJORITY REPORT. Qk that 65 per cent. of the total number of Societies in England comprise only 2 per cent. of the total number of insured persons, while 2} per cent. of the Societies include 76 per cent. of the insured persons. (Kinnear, Q. 23,553.) 204. Approved Societies are not, as a rule, organised on any territorial basis, and while a certain number are restricted to persons engaged in particular occupations or group together those who share a common point of view, such as those which impose a temperance or a particular religious test, the Societies compris- ing the great majority of the insured persons are open to receive as members any such persons without regard to residence or occupa- tion or any similar test. CERTAIN CRITICISMS OF THE SOCIETY SYSTEM. 205. We have received evidence criticising the Approved Society system on a variety of grounds. Our attention has been directed to the extra work in accounting, auditing and in the general supervision necessitated by the existence of nearly 8,000 separate financial and valuation units. For instance, witnesses appearing on behalf of the Central Departments informed us that administrative saving would be effected by reducing the number of separate units (see Kinnear, Q. 638-643 and Leishman, Q. 1790-1791). Again Mr. Middleton, the Acting Chief Auditor, in replying to a question as to the work falling upon the auditors, said : ‘‘ The fewer the units the less work, because every unit entails a kind of a nucleus or irreducible minimum of routine which could be absolutely dispensed with if its real transactions were merged into the transactions of another existing unit.” ““ We might put it that 20 separate units of 250 members each would occupy two men for 30 days: that gives 60 man-days. A 5,000 membership group would occupy the two men for about 12 days : that gives us 24 man-days as against 60.” (Q. 23,256, 23 959) 206. These criticisms relate, of course, to the cost of central administration which is not borne by the insured persons. As regards the cost to the insured members themselves, Mr. Alban Gordon expressed the view (App. XIII, 6) that ‘‘ economi- cally the excessive number of small Societies with their multiplication of establishment charges cannot fail to be an expensive method of administration.” On the other hand we have no evidence that larger Societies are administered at a lower expense per head to their members than smaller Societies. The primary point in this connexion is not the size of the Society but its constitucion and the agencies through which, under that constitution, its operations are conducted. Regulations fix the maximum amount per head that may be spent on expenses of administration, and so far as savings within this limit provide a criterion of relative cost, the general body of small Societies

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