Full text : Report of the Royal Commission on National Health Insurance

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MAJORITY REPGRT.

119

pointed out that by grouping themselves in special Societies
agricultural workers would be able substantially to attain the
same ends, as they would thereby reap the advantages of their
light sickness experience in additional benefits which might
take the form of return of contributions. It is perhaps worthy
of notice that the claims of the agricultural population to be
conceded a reduced rate of contribution have again been put
forward. Thus, the National Farmers’ Union of Scotland contend
 (App. LXXI; Q. 19,172-19,399) that the rate of contribution
 is, in the case of agricultural workers, more than
sufficient to meet the cost of the benefits of that class, and that
a variable rate of contribution based on sickness risks should be
instituted. They point out that in the case of Societies consisting
preponderantly of members residing in urban districts the
contribution is only sufficient to support the normal benefits,
whereas purely agricultural Societies show large surpluses. They
state that ‘‘ Agriculture is a healthy industry and stands apart
from all other industries in this country. In all other respects it
is treated separately. For instance, it is not included under the
Unemployment Insurance Scheme, nor is it included in any projected
 legislation in regard to limitation of working hours. If
makes a distinet claim for separate treatment in this connexion ’.
They go on to urge that *“ in regard to agricultural workers there
should be a reduction all round in the contributions payable.”’
The National Council of Agriculture for England state (App.
LXXXV, 5; Q. 21196-21217) that the agricultural worker on the
average receives a low rate of wages, and is probably content to
receive a low wage partly because his occupation is a healthy one.
They contend that persons in more arduous and more hazardous
Occupations receive higher rates of wages and should ““ with that
high wage pay more for their Health Insurance than the agricultural
 worker.’
254. Another justification for differentiation in benefits lies in
the incentive which is thereby offered to good and careful administration.
 We think that it would be fatal both administratively
and financially if the persons charged with the responsibility for
considering claims for benefit felt that there was nothing to be
gained by doing their work well and thoroughly.

SOHBME TO MITIGATE INEQUALITIES OF BENEFIT.
255. While we cannot support the proposal for differential
contributions, we have come to the conclusion that the possibility
 of the existence of differences in the rate of benefits provided
by different Societies should continue to be a feature of the scheme
of National Health Insurance. We believe, moreover, that the
inequalities which have in fact been disclosed are only such as
could have been and were foreseen in 1911 by those whose
technical knowledge and experience enabled them to gauge the
probabilities. It is true that as a result of the War the actual

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