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 IX. Inequalities of benefit in different approved societies

Collection:: Economics Books

| & MAJORITY REPORT. a system might have some advantage over the present system, but we fail to see how it could be expected to solve the particular problem with which we are here dealing. Under the present system an insured person is free to choose the Society to which he shall belong, and if he selects a Society which proves to be relatively unsuccessful and, as a consequence, unable to provide substantial additional benefits, he is, to some extent, responsible for the unfortunate position in which he finds himself. Iz, however, Societies were organised on a territorial basis and every insured person were compelled to belong to a particular Society determined solely by his place of residence, it would be far less easy to justify the position arising as a result of the more favourable experience of some Societies than of others. Nor can there be any question that such a position would arise, as the difference of experience between, say, the County Society for Durham and the County Society for Dorsetshire would be sub- stantially the same as that between a society for miners and one for rural workers. 252. Our conclusion that a system of Territorial Societies would not avoid the disadvantage of widely different financial results on valuation receives illustration in the table printed as Part X of Appendix A to the Report of the Government Actuary on the first Valuation (Cmd. 1662). In that table is shown a summary of the results of local societies and branches in England, grouped under the counties in which their offices are situated. (The large centralised societies are not included, but the table covers nearly four million insured persons.) The average net surplus per member is 24s. From this average there are variations ag high as 39s. 1d. in Sussex, and as low as 5s. 1d. in Northumberland and Durham. The experience of all the separate counties shows that no uniformity of results is to be expected from a system of Terri- torial Societies. JUSTIFICATION FOR VARIATIONS IN BENEFITS. 253. After the most careful consideration of the subject we have come to the conclusion that with a flat rate of contribution from all insured persons, whatever their liability to sickness, the pro- vision of varying benefits can be justified. We are impressed by the fact that the inequality of experience between different Societies is accompanied by a considerable inequality in wages. For example, agricultural workers who receive lower wages than the average artisans show better results under National Health Insur- ance. It was mainly on the ground that agricultural workers are on the whole less liable to sickness than persons engaged in other occupations that a demand was made on their behalf in 1911 for a lower rate of contribution and it was chiefly on the ground of the administrative difficulties of differentiation in the rate of contribu- tion that this demand was resisted. At the same time it was

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