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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APPENDIX A. a Je pe) de, ip AAA 3. The Contingencies Fund is, in effect, a sub-account of the Benefit Fund to which after each valuation its accumulated balances are trans- ferred. The contributions credited to the Contingencies Fund thus constitute a part of the provision made for benefits and we have regarded the consideration of them as falling within the scope of our terms of reference. 4. The following factors enter into the financial basis of the system : (a) The rate of interest at which the funds are assumed to fructify by investment; (b) the probability of survivorship from age to age; (c) the average amount of sickness and disablement benefit payable in each year of age; (d) the probability that maternity benefit will be payable in each year of age; (e) the probability, at each age, that an unmarried woman will marry and cease to be insurably employed ; (f) the probability that an insured married woman will become a widow in passing through each year of age; (9) the claims for sickness and maternity benefit under the special terms and conditions applicable to women who have recently left insurable employment on marriage. (Class K.); In respect of (b), (¢) and (d) the cases of men and women require to be separately considered, and in regard to women the cases of the unmarried (spinsters and widows) and the married must be distinguished so far as concerns (¢) and (d). The factors (e), (f) and (g) arise only in the case of women. (h) the average number of weeks during which an insured person will be unemployed in each year; (i) the cost of medical benefit; (k) the provision to be made for expenses of administration. The question submitted to us requires us to consider each of these factors. We deal with them, seriatim, in the following paragraphs. 5. Before proceeding to this stage we think it necessary to refer to certain considerations which arise out of the peculiar conditions governing the finance of the system of National Health Insurance. The system is operated through a large number of financially independent or semi- independent units, either societies or branches of societies, and these units differ materially from one another in their experience in respect of the greater number of the factors enumerated above. The contribu. tions are nob, however, equated to the varying risks undertaken by the separate units; they are uniform in amount for all insured persons of each sex, and the Reserve Values, representing the estimated loss arising from the acceptance of persons of higher ages than 16 at the rate of contri- bution appropriate to that age, are likewise uniform in amount for all persons of the same age and sex. It follows that widely differing results are found on the valuation of the separate societies and branches, and no rearrangement of the financial basis which retains the present uniformity of contributions can avoid this feature. The discrepancies between the basic assumptions as to the cost of the risks undertaken and the realised facts of the working of the societies, which are inherent in the existing system, might be held to invest us with a wide discretion as to the provision to be made, on the uniform basis, for the liabilities of the future. It is clear, however, that Parlia- ment intended the scheme to be solvent regarded as a whole whatever might follow from the grouping of risks incidental to the voluntary segregation of insured persons in Approved Societies, and we read our terms of reference as requiring us, in advisine anv chances. to conform

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