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

299 
MAJORITY REPORT. 
to Questions 23,648-23,650 and 23,666-23,681, from which we 
quote the following :— 
““ Although exempt persons are a small class and require 
special administrative arrangements, I think the abolition 
of the class would hardly be justifiable. Exemption is 
useful for many persons who, although employed within the 
meaning of the Act, are not regularly employed, or are 
already provided for in case of sickness, and it thus provides 
a certain elasticity in a compulsory scheme. The obligation 
of employers to contribute for such persons should also be 
maintained. Although in practice there might not be much 
risk of discrimination in favour of employing exempt 
persons if no contributions were payable, there might be a 
tendency in some cases in this direction, and it is a sound 
principle that the employer should have to pay his quota 
to the funds according to the labour which he employs, 
without regard to the individual circumstances of the 
employees. . . . I am inclined to think that as these 
persons have been entitled to medical benefit for some years, 
and the statistics go to show that the great majority of them 
do take advantage of the medical benefit which is provided 
for them, to deprive these persons of the benefit which they 
have enjoyed for so many years would be rather a retrogade 
step, and, on the whole, I think employers would agree that, 
as they are required to pay contributions, it is only right 
that those contributions should be applied in the interests 
of the health of their employees. o 
531. The Federation Committee of the English, Scottish and 
Welsh Associations of Insurance Committees (App. XXXVI, 
170-173) and the British Medical Association (App. XIL/VIIL, 15 
(b); Q. 14,891-14,893 and 14,923) think that the right to medical 
benefit should be withdrawn ; while the Scottish Association of 
Insurance Committees (App. XXXVII, 76 and 93) suggest that 
the contributions paid in respect of exempt persons should be paid 
to the General Purposes Funds of Insurance Committees. The 
Standing Committee of Scottish Insured Women urge the 
abolition of the class, and suggest that if it is retained the title 
to medical benefit should be withdrawn and the contributions 
paid into the Central Fund for the benefit of the members of all 
Societies (App. XLVI, 12; Q. 14.,530-14,531). 
539. After full consideration of the subject we are of opinion 
that the class should be retained with the present arrangements. 
Tt provides in many cases a useful niche for that class of persons 
who will probably be subject to compulsory insurance only for 
a short period and who do not in that period desire to become 
members of Approved Societies. These persons are not in need 
of the cash benefits; but the medical benefit gives them some- 
thing which is valuable and which they appear to appreciate.
	        
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