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

1’ Ud MAJORITY REPORT. of continued approval of Societies. While some witnesses have expressed the view that it is neither practicable nor desirable tc impose any such minimum limit, others have suggested a limit varying from 500 (Independent Order of Rechabites, Q. 6178- 6179) to 100,000 (National Conference of Industrial Assurance Approved Societies, Q. 4990). We have been informed that some of the defects in administration which are manifested from time to time are attributable in certain cases to smallness of member- ship, and in particular to the fact that it may not be possible, within the amount available for expenditure on administration, to secure the services of competent officers (Kinnear, Q. 537,589). On the other hand we are assured that the efficiency of a Society does not vary in direct proportion to its membership, and that there are small Societies whose administration is entirely satis- factory as well as large Societies where this is far from being the case (Kinnear, Q. 23,562, 23,587). We are also informed that from the point of view of actuarial soundness and financial stability, a large membership is not essential (Kinnear, Q. 535; Leishman, Q. 1892). Moreover, we feel that the present wide- spread system of local administration through small units has the advantage of providing a closer touch between the individual insured person and his Society, and enables a very large number (estimated to be as high as 100,000) of working men and women to gain some experience of public work and social administration, with results which cannot fail to be for the general good. If is, moreover, in the Societies of this type that the tradition of voluntary and public spirited service is often best maintained. The disappearance of this tradition could not, in our opinion, be viewed otherwise than with regret. 230. We feel, therefore, that it would be inexpedient to place any arbitrary restriction on the size of Societies without regard to the quality of their administration and their effectiveness as self- contained insurance units. At the same time we think that there should be adequate provision for dealing with Societies whose administration is deficient in any respect. This is, how- ever, not a matter which can be confined to small Societies, and we shall return to it later in relation to Approved Societies in general. CONTROL BY MEMBERS. 231. The next point of criticism of the Approved Society system as it now exists is that, although one of the main reasons advanced in support of the adoption of the system was that it would place the management and control of National Health Insurance business in the hands of the insured persons themselves, yet in actual practice this has not been the result, so far, at any rate, as many millions of insured persons are concerned. We have had ample evidence (National Conference of Industrial Assurance Approved Societies, Q. 4568-4743) that in some of the

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