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

MAJORITY REPORT.

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ances under the Health Insurance Scheme, there would be
introduced a new factor which would operate to the financial
advantage of certain Societies as compared with others and which
would accordingly increase the number of influences making for
deviations from the general average experience among Approved
Societies.

DEFINITION OF DEPENDENCY.

317. We have spoken above of allowances for dependants in
general terms. It is now necessary to consider a little more
closely what should be the scope of the term ‘“ dependant *’ to
be adopted for the purpose of the benefit. In this connexion we
would direct attention to Sir Walter Kinnear’s reply to Question
23.460.

318. The statutory definition adopted for the purpose of
Unemployment Insurance is sufficiently wide to include such
persons as the housekeeper of a widower who has charge of his
children, or an ‘* unmarried wife.” The provision of dependants’
allowances to persons of these types is perhaps relatively simple
in the case of Unemployment Insurance, as this is administered
by a Government Department which is in a position to issue
exact instructions to all its local branches and thereby to enforce
uniformity in the distribution of benefits throughout the whole
insured community ; but in regard to Health Insurance the case
is otherwise. and we think that the administration by Approved
Societies of dependants’ allowances in respect of such persons
would be an extremely difficult matter.
319. Another consideration to which we must have regard in
the case of the unmarried wife is that the granting of such allowances
 would be inconsistent with the title to a widow's pension
under the Widows’, Orphans’ and Old Age Contributory Pensions
Act. Many Approved Societies would, moreover, probably raise
serious objection to making payments in such cases.

320. We have considered the practicability of limiting the
definition to ‘‘ those persons living in the household who are
dependent upon the insured person, and any of his children residing
 outside the household.” It has, however, appeared to us very
desirable to avoid any definition which would place upon Approved
Societies the onus of making inquisitorial investigations into the
private circumstances of a member and his household. Further,
the adoption of this definition would add very materially to the
administrative difficulties of the Societies, and would probably be
followed by a claim from the Societies for a substantial increase
in the amount allowed for administrative expenditure.

321. With regard to those cases in which husband and wife
are both insured persons, we consider that the payment of
dependent children’s allowances in the event of the illness of
            
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