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

| LR i MAJORITY REPORT. involve the separation of administrative and financial responsi- bility, a result which could not, in our opinion, be defended. This is a serious consideration and one involving more than a mere change of method in the administration of the Health Insurance system. We feel that it is to the public advantage that this great Scheme should be administered by the representatives of the insured persons themselves, and that the governing bodies should have that full responsibility for the results of their own activities without which it is as hopeless as it would be unreasonable to look for a high standard of efficiency and vigil- ance. In this connexion we realise that there are features of the system which must appear to many as defects, and that these cannot be eradicated from it. On the other hand we cannot dis- regard the consideration that opinion as to faults and defects in a Scheme of this kind is largely a matter of the individual stand- point, and that what amounts in the eyes of some to a flaw will commend itself to others as an element of equity and justice. Tt is clear that if effect is to be given to the views of one school of thought, acute dissatisfaction will be aroused in the minds of those who hold the contrary opinion and regard the present machinery as equitable in its operation. We do not ourselves think that the best interests either of the State or of the insured population would be served by a vast amalgamation of all the resources of the Scheme in a common fund administered from the centre, and for the reason given we are satisfied that such an amalgamation would create as much discontent as it would allay. From this point of view, therefore, we have come to the con- clusion that a system of self-governing bodies is to be preferred and should be retained. 292. As to the other type of criticisms, the substantive plea behind which is that the system of administration through the Approved Societies is open to so many objections that some new method of administration should be substituted for it, we have to take note of the fact that the Approved Societies are in possession of the field, by the action of Parliament, that they have their organisations widely distributed over the whole of the country and their staffs trained in the details of what, in many respects, is an intricate piece of social administration. The onus of showing that the system, either from causes inherent in itself, or from personal shortcomings of those by whom it is operated, works so imperfectly that it ought to be abolished, rests upon those who take this view. We have considered their evidence with care, and, we trust, without bias. We have also reviewed the evidence given to us by the large number of officials who have appeared before us as representing the Societies, and we have studied their attitude of mind in their relations with the insured person and their work generally as revealed to us by the answers given to the many questions which we have put to them. In the result we have come to the

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