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

MAJORITY REPORT. 
201 
a year is not entitled to medical benefit, and in such cases the 
contribution is reduced by 2d. 
471. We have received no evidence of any considerable demand 
for the extension of the existing facilities for voluntary insurance. 
Some societies have pointed out the limited number of the class 
and have commented on the fact that a large proportion of volun- 
tary contributors do not continue the payment of their insurance 
contributions for more than a few years. The National Amalga- 
mated Approved Society, for instance, informed us (Q. 10,581- 
10,585) that of a total membership of approximately 2% millions 
they had only 2,023 voluntary contributors, and that the tendency 
was for such contributors soon to drop out of insurance. Similar 
evidence was given by the Ancient Order of Foresters (Q. 4392- 
4395) and the Independent Order of Oddfellows, Manchester 
Unity (Q. 5815-5816; 6082-6084). The Act expressly provides 
that no married woman may be insured as a voluntary contri- 
butor. This restriction was no doubt included in the 
Act because of the extreme difficulty of supervising married 
Women in receipt of Sickness or Disablement Benefit, and in 
Particular, of seeing that the insured person does not, during sick- 
hess, continue to carry on to a greater or less extent her normal 
household duties. The National Union of Societies for Equal 
Citizenship have urged that this restriction should be withdrawn, 
and that married women should be allowed to be insured as 
Voluntary contributors on the same terms as any other persons. 
(App. XCIX, 8; Q. 22,986-22,990; 23,007-23,009 and 23,013- 
23,018.) 
472. In view of the serious difficulty just indicated we cannot 
fecommend the adoption of this proposal. It must, however, 
be borne in mind that as regards maternity benefit, the married 
Woman, who is not herself insured, will ordinarily be entitled :o 
the henefit by virtue of her husband’s insurance ; and where the 
hushand is not employed, special provision has now been made 
Under the Widows’, Orphans’ and Old Age Contributory Pensions 
Act entitling the husband to become insured as a voluntary con- 
Eributor if his wife was herself an insured person before marriage. 
If the uninsured wife of an insured man were permitted herself 
to become a voluntary contributor, the effect would be to evoke 
a double contribution for her existing rights to a widow's pension 
and g pension at 65, since contributions have to be paid under 
both Schemes by a single stamp. 
473. The special conditions as to the reduction of con- 
tibutions and the cessation of title to medical benefit in the 
¢ase of voluntary contributors whose income exceeds £250 a 
Year, and the provisions relating to the penalties for arrears in 
the case of such contributors, do not appear to have given rise 
0 undue administrative difficulties, and although one Society 
(Rational Association Friendly Society, App. IX, 25: Q. 6565
	        
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