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 XIII. Miscellaneous questions

Collection:: Economics Books

164 MAJORITY REPORT and Old Age Contributory Pensions Act. Under that Act from January, 1928, the higher age limit for the payment of contribu- tions and for the title to sickness and disablement benefits under Health Insurance will be reduced from 70 to 65, at which age the title to contributory old age pensions will mature. We are satisfied that even where a person continues in employment after he has become entitled to an old age pension, it would be undesirable that he should be entitled, in addition to that pension, to receive sickness benefit when unable to work through illness. We note also with satisfaction that the Contributory Pensions Act provides that all persons who remain in insurance up to the age of 65 are to continue to be entitled to medical benefit for the rest of their lives. This provision sufficiently meets a case on which we received some evidence in the earlier stages of our inquiry, viz.: that of persons who cease employment before the age at which, under the Act as it now stands, the title to medical benefit for the rest of life is secured. We do not feel it necessary to make any recommenda- tion with respect to the medical benefit of persons whose employ- ment ceases before the age of 65, as it may be expected that such persons will now have a greater inducement to continue their insurance as voluntary contributors up to that age in order to preserve their valuable rights under the Contributory Pensions Act. 459. On the question of the income limit for insurability, we have carefully considered the proposal of the British Medical Association, that such a limit should be fixed for manual as well as non-manual workers. (App. XLVII, 8-18; Q. 14,689- 14,708, 14,806-14,817, 14,914-14,944.) We are definitely of opinion that such a change would be undesirable. We think that the present principle which draws a firm distinction between manual and non-manual labour beyond a certain point is sound, inasmuch as the manual worker, whatever his earnings at any moment may be, is generally subject to economic conditions which render an insurance provision highly desirable. Where a manual worker is gaining a high rate of remuneration, it will generally be found that there is an element of instability of some kind in his employment. His work may be subject to broken time, or he may be seriously exposed to the graver evil of unemployment. Alternatively, his wage rate may be sub- ject to considerable variation. In either case his rate of remuneration at any moment will furnish an unsatis- factory indication of what he may gain over a relatively lengthy period of time such as a year. There is the further point that in such cases the insured person might, on any income limit, be alternately, and with consider- able frequency, entitled and disentitled to medical benefit. The only practicable method of dealing with this administrative diffienlty would be to determine prospectively for a certain period

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