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 V. The development of the health services

Collection:: Economics Books

(:) MAJORITY REPORT. a mn 128. Between these extremes lie those who would retain the insurance principle as a means of raising part of the necessary funds and would weave it, in some way not very clearly defined, into the financial web. For example, the British Medical Asso- clation contemplate a line drawn horizontally across the structure of society. Above that line everything is to be left tc private effort, except those services which are of a, public health character in the strictest sense. Below that line they would admit a com- prehensive service embracing all medical elements and incor porating all the activities of the local authorities which stand at present apart from the insurance service. The service which would thus be limited so far as concerns those for whom it would be available, although in its content of the widest scope, would be financed from a combination of public and insurance funds. The principle governing the limits within which such a service would be available is enunciated in the following words ** The medical provision should be available for those persons, and only for those persons, who would be unable to obtain it without the help of an Insurance Scheme the medical provision made for such persons should be, as far as possible, complete.”” (App. XI, VII, 8; Q. 14,689-14,708, 14,806-14,817.) In other words, the witnesses who appeared on behalf of the British Medical Association, contemplate a unified and complete service resting in part on insurance funds which should, however, be restricted to the poorer classes of the community. 129. On the other hand, such a scheme would be broader than the present scheme of Health Insurance, as it would ignore the distinction between those employed under a contract of ser- vice, and those working on their own account who are at present outside the scope of the Acts. This scheme would, moreover, include the dependants of both these classes. We questioned the witnesses closely as to the income limit at which the line should be drawn, but did not receive any very definite suggestion on the point. They apparently contemplated something sub- stantially higher than the present destitution test for the com- plete medical attention given by the Poor Law authorities, but lower than the present insurability limit for non-manual workers (£250 a year), with the further proviso that dependants should only be included if the person on whom they were dependent had an income substantially below that figure. The general effect of these proposals would be to exclude from the scheme instituted by the State a substantial number of the present insured class but to bring within the scheme a greater number than those so excluded, consisting of the dependants and of the various classes of persons of small means at present outside the existing insur- ance scheme. To this enlargement of the sphere of * contract practice,” there appeared to be no objection on the part of the British Medical Association, assuming that a sufficiently low income limit should be conceded in defining those for whom

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