The fiscal problem in Missouri

Report of the Royal Commission on National Health Insurance

Bibliographic data

Monograph

Identifikator:: 1833271335

URN:: urn:nbn:de:zbw-retromon-230042

Document type:: Monograph

Title:: The fiscal problem in Missouri

Place of publication:: New York

Publisher:: National Industrial Conference Board, Inc.

Year of publication:: 1930

Scope:: xvi, 359 S.

Digitisation:: 2022

Collection:: Economics Books

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Chapter

Document type:: Monograph

Structure type:: Chapter

Title:: Chapter I. State and local expenditures

Collection:: Economics Books

3 he & in mn He 1d yn 8, at re ve to ne he es al at ve 29 be to YM ve 11s to as ld er ve d. ud ire ut er ve 3T'e he lth red an he MAJORITY REPORT. Q! 7 employer’s share of the contribution would be possible, but would probably give rise to dissatisfaction as reducing the employer's share of the joint contribution below that of the worker, a position which, in any case, would be inconsistent with that existing in the case of women, where the employer pays for the combined health and pension benefits 1d. a week more than the worker. These difficulties in the way of devising any reduction of con- tributions which would be free from serious objection preclude us from recommending that the margin should be utilised in this way. In coming to this conclusion we are assisted by the fact that, in view of the small margin available, no reduction of the contribution would be possible, in any case, in respect of women. 187. There remains the possibility of using the margin, or part of it, to reduce the charge upon the State. - We do not regard it as falling within our province to consider whether such a reduction should be made, but we have been impressed by the extent to which the original conditions under which the State grant was fixed have been altered by subsequent events, and we think it incumbent on us to explain the situation as it presents itself to us. 188. We have shown in paragraph 160 that the State grant was fixed at two-ninths of the benefits in consideration of the imposition upon the contributions of the insured persons and their employers of the liability to provide the necessary reserves in respect of seven-ninths of the benefits for the population brought into insurance at the outset. It followed from this arrangement that from the increase of benefits in 1920 up to 31st December, 1925, the charge upon the contributions for this purpose was 12d. a week in the case of men and 13d. a week in the case of women. By the Pensions Act of 1925 these rates were reduced, respectively, to 1d. and ‘90d., while the Actuarial Committee recommend, in connexion with the change of basis, that if the margins are applied uniformly over life, as explained above, they should be further reduced to .-80d. and -60d., respectively. 189. Reductions of over 50 per cent. in the contributions of the insured for the redemption of reserve values are thus envisaged. At the same time the Exchequer continues liable to provide its correlative grant of two-ninths of the expenditure on benefits, and this is only to be abated by the cessation from 1928 onwards of the grant in respect of sickness and disablement benefits to persons aged between 65 and 70, a relief which amounts to no more than 7 per cent. of the full charge. The disparity between the relief which is to accrue to the insured persons and that which the State obtains on its related obligation is emphasised by certain of the causes to which the reduction in the reserve values is due. These are the provision of pensions at the age of 65, which has imposed a heavy charge on the State, and the increase in the rate 34702 D 9

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