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 XII. Consideration of certain major problems

Collection:: Economics Books

156 MAJORITY REPORT. side, it follows that an unrestricted non-contributory dental benefit would cost at least 4s. per insured person per annum, which is the equivalent of a penny contribution. If the percen- tage of applicants exceeded 5, as in course of time it probably would, or the average cost per case exceeded £4, as in many areas it does at present, the total cost of a ** 100 per cent.”’ service would exceed the equivalent of a penny contribution. 353. The establishment of a complete dental service for the insured might, as we have said, be followed sooner or later by a reduction in the expenditure on sickness and disablement benefits, which would to some extent be a set off against the new expendi- ture. But this is a wholly conjectural factor, and no effect can be siven to it for the purpose of framing actual estimates. METHODS OF RESTRICTING LIABILITY. 354. If an unrestricted service is too costly under present con- ditions, the question arises whether the liability could be limited. In examining possible methods of limitation we have to weigh the ultimate gain in the improved dental condition of the insured people against the claim to immediate relief of those actually suffering in health owing to neglect of the teeth. From the medical point of view there are obvious advantages in concen- trating on the treatment of young persons and in spending the money on conservative work. But such a policy is not likely to be acceptable, since it does nothing for those older persons whose mouths are in such a condition as to produce digestive and other disorders resulting in present suffering and, what 1s important as an insurance consideration, consequent demands on the benefit funds. The two conflicting points of view might possibly be reconciled by making no charge for conservative and operative treatment, but requiring the insured person to contribute a sub- stantial proportion (say 50 per cent.) of the cost of dentures. Such a proposal is open to the obvious objection that it would tend to exclude the most necessitous of the insured population who need dentures and who could not afford £2 or £3 towards their provision. (See Brock, Q. 23,943.) This difficulty might, to some extent, be met by allowing Societies some discretionary power in cases of proved need to contribute the balance as an additional benefit. We recognise that such discretionary benefits are difficult to administer and are liable to abuse. But it does not seem to us impossible to devise tests which would afford at least a partial safegnard against administrative abuses. No restricted service can ever be quite satisfactory, but the restrie- tion we have suggested seems to us least open to objection. 355. An alternative method of limitation would be to make the benefit recommendatory and to leave the selection of cases to the Insurance Committees or their successors. on the basis

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