Report of the Royal Commission on National Health Insurance

Bibliographic data

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:: Minority report

Collection:: Economics Books

304. MINORITY REPORT. 92. Yet Section 107 is a dead letter, and that this is so is largely due to the fact that membership of Approved Societies is scattered all over the kingdom instead of being localised, and that in one street, or indeed in one house, every inhabitant may belong to a different Society, each with its headquarters entirely out of reach of the ordinary insured member. 23. This brings us to another essential point laid down by the framers of the Act. The scheme was to be democratic, con- trolled by the insured for the insured. Here again the Act is almost a dead letter, and we feel that in this case also the con- stitution of the Societies renders it inoperative. 24. The statement of our colleagues that most people do not ‘“ maintain that degree of interest in public affairs which good citizenship postulates ’ is of general philosophic interest, but it appears to us to have no bearing on the question before us. In every class of life people are interested in matters which affect their pockets, and the fact that insured mémbers are not interested in the management of a scheme which involves deductions from their wages and accruing benefits, suggests something very wrong with the machinery. We believe that different results might be achieved if these Societies came under the control of the Tiocal Authority. This would limit their numbers to about 150 Societies as against 7,876 existing financial units. The best officers already trained in Approved Society work would be avail- able and the varying occupational risks which at present aggravate inequalities would be modified by territorial grouping. THE APPROVED SOCIETY SYSTEM. 25. We have reviewed the system of Approved Societies in order to ascertain on the one hand whether it has fulfilled the intentions of Parliament, and on the other hand, whether it is the most effective method of administering a scheme so closely related to public health in all its phases. 26. With regard to the first part we are definitely of the opinion that the wide disparity in valuation results was not contemplated by Parliament, and that the complete lack of any real opportunity for membership control, affecting over half the insured population, has rendered almost negligible a feature of the system to which Parliament attached very great importance. 27. The views adduced that in general the free choice of Society disposes of any suggestion of hardship upon the members of Societies with no surplus, does not in our judgment dispose of the matter. Nor do we agree that this segregation of the insured population into Societies is an essential part of a scheme which some witnesses consider embodies a ‘* true insurance principle.’’ 28. We are aware that the generous estimate of the liabilities of the Act which has hitherto formed the actuarial basis. has been

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