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. - fy ™~ benefits in various circumstances of need where such assistance may be desirable. We are merely concerned to point out that beyond a certain point such claims may become inconsistent with the arrangements under which society is at present created and continued. ven the State cannot accept, since in certain contingencies it might not be able to meet, an undefined liability, and it follows that in theory the State can only assume full respon- sibility for the maintenance of all within its borders, if simultaneously there is conceded to it a greater power of contrcl over the constitution of society from generation to generation than has ever before been considered either desirable or practic- able. If the State is to be a generally beneficent organisation, it can only be on the assumption that it has previously sanctioned the existence of those whose claims it is bound to honour. For such an assumption there is at present no warrant, and it may with reason be contended that unrestrained freedom in the individual to beget life, and communal responsibility for the maintenance of life, are ultimately incompatible. As before, we are arguing neither for one side nor the other; we are merely concerned to point out that certain current ideals which have coloured much of the evidence put before us, are inconsistent with the general structure of society. 7. On a review of the evidence we cannot but feel that there is considerable confusion in certain quarters with regard to the relation which exists between the care of the individual’s health and the wider question of the promotion of the health of the community. Obviously the medical profession can give curative treatment. to individuals alone ; obviously also a community in which every individual is healthy will be a healthy community. It seems in consequence to be frequently assumed that by merely attending to the health of individuals, a healthy population will finally emerge. We believe this to be a profound error, and we are glad to be able to cite the evidence of the British Medical Association that the organisation of a National Health Insurance Scheme (which primarily relies on giving medical benefit to individuals) is not even probably the best means of utilising limited resources for the promotion of national health. We are also glad to be able to quote their view that *‘ the alleviation or cure of morbid conditions when once they have arisen’ is, relatively to other matters, a minor part in the campaign for public health. Tt is perhaps not reading too much into the evidence of the British Medical Association to suggest that they would not dissent from the view that the function of the practis- ing doctor in raising the general health of the nation to a higher level is, from a certain aspect, less important than is sometimes assumed. In the case of the large volume of ill-health which is ultimately due to environment or occupation, the doctor may from time to time cure the individual. But ill-health will remain if the causes of ill-health remain, and the fundamental problem

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