Report of the Royal Commission on National Health Insurance

Bibliographic data

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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Chapter

Document type:: Monograph

Structure type:: Chapter

Title:: Chapter IX. Inequalities of benefit in different approved societies

Collection:: Economics Books

MAJORITY REPORT. 115 being five times the lowest and that large blocks of insured persons are included at each stage of the range. The fact that 1,880,630 insured persons failed to participate in any surplus at all while more than one-third of that number were entitled to the full five units is worthy of note; we think that the diagrams referred to furnish the most graphic exposition of the financial results of segregation under the present system. CAUSES OF SURPLUS. 247. The emergence of a surplus on valuation is due to a great variety of causes, some within and others outside the control of the Society. We propose here, however, to refer only to those two possible causes which were most frequently mentioned in evidence before us. The first is the segregation within a Society of lives much above or much below the general average as regards liability to sickness. For example, a Society composed mainly of rural workers could hardly fail to show a much more favourable result on valuation than a Society composed mainly of chemical workers. The second cause of surplus which was constantly quoted in evidence was careful administration, particularly as regards the supervision of claims for benefit. Undoubtedly, good administration must be a contributing cause to a satisfactory valuation result, even if it is thought that when compared with the other cause to which we have referred, it has been but a minor factor. We should like to make it clear that in advancing this proposition we are in no way lending our support to any suggestion that good administration is relatively unimportant. But we are inclined to think that, even if it were possible hypothetically to assume a uniform standard of administration throughout all Societies, the discrepancies which would have resulted would have been almost as great as those which have in fact emerged, and we are strengthened in this view by the consideration that there are prosperous Societies in which administration is not strict and unfortunate Societies which are unfortunate despite strictness of supervision. RESULTS OF SEGREGATION. 248. The evidence which we have received on this matter has inclined to one or other of two extremes, each of which can be supported by arguments of some force, but neither of which, as we shall show later, commends itself to us. On the one side it has been represented that the position which has now revealed itself as the result of the first two valuations was only to be expected and was clearly foreseen and explained and defended in the most definite terms when the scheme of National Health Insurance was first before Parliament in 1911. Our attention has been called to various statements, in Parliament and else- where by responsible Ministers and others, containing pledges

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