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

MAJORITY REPORT. 
259 
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administration allowance has been found to be sufficient.” 
They submit, however, that the allowance is insufficient where 
the membership lies between 5,000 and 10,000. 
619. It has been suggested by some witnesses that a variable 
rate of allowance should be instituted according to the size and 
type of Societies. For instance, the National Association of 
Trade Union Approved Societies (App. XCII, 144-148: 
Q. 22,074-22,075) point out that the rate of administration 
expenditure varies according to the type and size of Society. 
They suggest that the Ministry should be empowered to vary 
the amount in the case of Societies with a membership between 
& given minimum and maximum. They also make the specific 
suggestion that the allowance should be increased to 4s. 10d. 
Per member per annum in the case of Societies with less than 
50,000 members, and that an additional twopence per member 
should be allowed in the case of women. The Hearts of Oak 
Benefit Society (Q. 2972-2974) and the Order of the Sons of 
Temperance (Q. 21,590) also think that the rate of allowance 
should be varied according to the type and size of Society. We 
are not convinced that there is much substance in this claim. 
On the contrary, we see grave objections to the adoption 
of a differential rate of administration allowance as 
between different types of Societies. The adoption of 
such a device as we have indicated might with some justice be 
represented as, and it might in fact easily become a contrivance 
for subsidising the administration of certain forms of organi- 
sation at the cost of their own members’ benefits. Health Insur- 
ance exists to promote the advantage of the insured, in whose 
interests it is essential that there should be throughout the whole 
administration of the Act a spirit of wise economy. No Society 
and no type of Society can claim a prescriptive right to a 
guaranteed existence, quite apart from any question of the cost 
of its administration. While inevitably in the multitude of 
Societies there will be differences in the cost of administration, 
1t is, we consider, a sound principle that no Society in respect 
of its administration should require a sum materially in excess 
of that which the great bulk of other Societies find sufficient. 
Economy is, after all, one essential constituent of efficiency, and 
any type of Society which is less markedly economical than other 
Societies, is ultimately to be condemned as inefficient. Apart 
from these general considerations we do not consider that 
differential rates for administration allowance would in any case 
be defensible in a scheme subject to statutory provisions under 
which uniform contributions are charged; moreover, we are 
advised that difficulties would arise in connexion with the 
Valuation of Societies if effect were to be given to such a 
Suggestion. We, therefore, recommend that no change in the 
existing provision should be made except in respect of the matter 
dealt with in paragraph 242 of our Report.
	        
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