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:: Reservation by Sir Andrew Duncan and Professor Alexander Gray

Collection:: Economics Books

MAJORITY REPORT : RESERVATION. 298 portioned to the number of employees, we doubt whether in discussions on the reactions of the cost of Health Insurance on the trade and industry of the country, the consequences of the present arrangements are always appreciated. At present the contribution made by employers to the Health Insurance Fund is roughly proportioned to the wages bill, but the wages bill has no necessary relation to the profits of a firm. In consequence, a firm employing a large staff will contribute largely to the Health Insurance Fund, even though it be in a depressed trade and may not at the time be covering even overhead expenses; on the other hand, provided it employs few men, a prosperous firm will contribute but little. It follows from this that the ultimate incidence of the tax and its reaction on trade may vary greatly from one industry to another. In certain cases it may doubtless be possible in large measure to pass the burden on to the consumer ; elsewhere this may be wholly impossible. ~~ When account is taken of the further contributions for Unemployment Insurance and Widows’ Pensions very large sums may be involved in the case of a firm employing many men, and in extreme and unfavourable circumstances the burden of the social services may become almost crippling. We consider it all the more important to emphasise that there can be no easy generalisation as to the incidence and the effects of the insurance contribution, since so eminent a writer as Mr. R. G. Hawtrey has recently lent the weight of his authority to the doctrine that °‘ the employer’s share falls on the workmen just as much as the rest ”’ and he describes as a ‘‘ transparent device '’ the arrangement under which a part of the cost is ** ostensibly ’* imposed on the em- ployer. We are not aware of anything either in economic theory or in actual practice which justifies this conclusion. The burden imposed by social insurance on industry is in certain cases very real and, unfortunately, it is at present most onerous where there is least capacity to bear it, in those industries, as it happens, which are most essential to the country’s prosperity. In the case of the sheltered occupations little inconvenience may arise; the burden may be borne or passed on. But in the case of the unsheltered industries, where the full rigour of foreign competition has already produced a position of grave embarrassment reflected in the unemployment returns, it is not permissible to regard the burden of social insurance as negligible and free from possible detrimental reactions on the prosperity of the country and indeed on the employment of the worker. 4. Apart from these two questions there are, further, three matters of general principle, in certain respects inter-related, on which, as it appears to us, not a little misapprehension prevails. We should like the following observations on these questions to be read not merely as supplementing, but perhaps to a certain limited extent as modifying, our concurrence in the terms of the Report signed by our colleagues.

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