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 con- 
tend (App. LXXI; Q. 19,172-19,399) that the rate of con- 
tribution 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 pro- 
jected 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 agri- 
cultural worker.’ 
254. Another justification for differentiation in benefits lies in 
the incentive which is thereby offered to good and careful adminis- 
tration. 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 possi- 
bility 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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