164 
MAJORITY REPORT 
and Old Age Contributory Pensions Act. Under that Act from 
January, 1928, the higher age limit for the payment of contribu- 
tions and for the title to sickness and disablement benefits under 
Health Insurance will be reduced from 70 to 65, at which age 
the title to contributory old age pensions will mature. We are 
satisfied that even where a person continues in employment after 
he has become entitled to an old age pension, it would be 
undesirable that he should be entitled, in addition to that 
pension, to receive sickness benefit when unable to work through 
illness. We note also with satisfaction that the Contributory 
Pensions Act provides that all persons who remain in insurance 
up to the age of 65 are to continue to be entitled to medical 
benefit for the rest of their lives. This provision sufficiently 
meets a case on which we received some evidence in the 
earlier stages of our inquiry, viz.: that of persons who 
cease employment before the age at which, under the Act as it 
now stands, the title to medical benefit for the rest of life is 
secured. We do not feel it necessary to make any recommenda- 
tion with respect to the medical benefit of persons whose employ- 
ment ceases before the age of 65, as it may be expected that such 
persons will now have a greater inducement to continue their 
insurance as voluntary contributors up to that age in order to 
preserve their valuable rights under the Contributory Pensions 
Act. 
459. On the question of the income limit for insurability, we 
have carefully considered the proposal of the British Medical 
Association, that such a limit should be fixed for manual as 
well as non-manual workers. (App. XLVII, 8-18; Q. 14,689- 
14,708, 14,806-14,817, 14,914-14,944.) We are definitely of 
opinion that such a change would be undesirable. We think that 
the present principle which draws a firm distinction between 
manual and non-manual labour beyond a certain point is sound, 
inasmuch as the manual worker, whatever his earnings at 
any moment may be, is generally subject to economic conditions 
which render an insurance provision highly desirable. Where a 
manual worker is gaining a high rate of remuneration, it will 
generally be found that there is an element of instability of some 
kind in his employment. His work may be subject to broken 
time, or he may be seriously exposed to the graver evil of 
unemployment. Alternatively, his wage rate may be sub- 
ject to considerable variation. In either case his rate 
of remuneration at any moment will furnish an unsatis- 
factory indication of what he may gain over a relatively 
lengthy period of time such as a year. There is the 
further point that in such cases the insured person might, 
on any income limit, be alternately, and with consider- 
able frequency, entitled and disentitled to medical benefit. The 
only practicable method of dealing with this administrative 
diffienlty would be to determine prospectively for a certain period