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

158 MAJORITY REPORT. would probably not be safe to attempt to provide such a service if the amount available was less than 6s. While we do not anticipate that the cost would be as high as 6s. at first, it might easily approximate to this as insured persons become better acquainted with their rights and realise the advantages of dental treatment. But we think that the re- stricted service we have suggested could be provided at the outset for about 3s. a head if the insured persons were required to contribute half the cost of dentures. A contributory scheme would reduce the number of applications, and the saving on denture cases would be considerably more than the amount con- tributed by the insured persons. But if the sum which it will ultimately be found possible to set aside for this purpose proves to be less than 2s. 6d., it would not in our opinion be desirable to attempt to provide a general dental benefit. A dental service costing less than 2s. 6d. a head would not be worth offering. The restrictions necessary to keep the cost within any lower limit would make the benefit irritating and to a large extent illusory. Treatment would tend to become a matter of chance rather than of right. 359. An alternative suggestion, which has much to commend it on medical grounds, would be to provide all conservative and operative treatment free but to leave dentures to be paid for by the patient or to be provided by the Approved Societies as an additional benefit. Such a dental service would be of great value to the younger insured persons and would not be costly to provide ; but a benefit which fails to provide the one form of treatment which the older insured people desire is not likely to be welcomed and we have not made any attempt to estimate the cost on this basis. METHOD OF PAYMENT OF DENTISTS. 360. If dental benefit were to become a normal benefit the question of the method of payment of the dentists might arise as a more important issue than it does at present. With the precedent of the success of the capitation method in medical benefit before us, we thought it desirable to examine witnesses on this point. Mr. Brock, in reply to Q. 23,952, stated that °° dental benefit does not lend itself to payment on a capitation basis at all. To begin with, there are no sufficient data available on which you could calculate a capitation rate, and if the adoption of a capitation system were proposed to the dentists they would be tempted naturally to insure them- selves by demanding an excessive rate.” He goes on in the same reply to cite other objections of a fundamental nature, and adds that there are really only two practicable methods of pay- ment, one the attendance basis with an agreed scale specifying the fee for each separate kind of service, and the other, payment

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