MAJORITY REPORT.
CHAPTER II.
THE SCHEME OF NATIONAL HEALTH INSURANCE,
HISTORY OF THE SCHEME.
7. The Scheme of National Health Insurance in this
country had its origin in the National Insurance Act of 1911,
which was described in its Preamble as ‘‘ an Act to provide for
insurance against loss of health and the prevention and cure
of sickness and for purposes incidental thereto.” The Scheme
came into operation on the 15th July, 1912, and had therefore
been in operation for a period of 12 years at the time when we
were appointed to make the first general and comprehensive
investigation into its working.
8. During these 12 years the Scheme of Health Insurance
has not been without its history—a history which is reflected in
a fairly continuous series of amending Acts of varying degrees
of importance stretching from 1913 to the Consolidating Act of
1924. These various legislative alterations may, broadly, be
ascribed to two main causes. In the first place, the original Act,
viewed merely as a piece of legislation, was planned on a generous
scale, and was drafted on the assumption that special provision
should be made for any class of the population which appeared
to call for special treatment. For example, aliens and those
workers whose conditions of employment guaranteed them pay-
ment of wages during a certain period of incapacity, were
the subject of special legislative provision. Moreover, other
sections of the Act aimed at dispensing justice as between indi-
viduals in matters where abstract justice could only be achieved
by machinery which in the circumstances could not fail to be
burdensome in administration. As examples of such it may be
permissible to cite the original provision made for the calculation
and the imposition of penalties for arrears, the provision with
regard to late entrants to insurance, and the arrangements for
transfer between compulsory and voluntary insurance. In
the light of subsequent events the original Act might be
criticised for its implicit underlying assumption that the indivi-
duals composing the population are * classifiable ’’ in a sense
in which, in fact, they are not. Consequently, no doubt, certain
sections of the Act, irreproachable in themselves and based on the
assumption that the population as a whole was stabilised, were
found to be out of touch with the realities of the situation.
In short, the original Act was in many respects complex
with a complexity which in practice yielded no adequate com-
pensating advantage, and the realisation of this fact led to one
series of amendments, those aiming at simplification of enactment
and of administration.