156
MAJORITY REPORT.
side, it follows that an unrestricted non-contributory dental
benefit would cost at least 4s. per insured person per annum,
which is the equivalent of a penny contribution. If the percen-
tage of applicants exceeded 5, as in course of time it probably
would, or the average cost per case exceeded £4, as in many areas
it does at present, the total cost of a ** 100 per cent.”’ service
would exceed the equivalent of a penny contribution.
353. The establishment of a complete dental service for the
insured might, as we have said, be followed sooner or later by a
reduction in the expenditure on sickness and disablement benefits,
which would to some extent be a set off against the new expendi-
ture. But this is a wholly conjectural factor, and no effect can
be siven to it for the purpose of framing actual estimates.
METHODS OF RESTRICTING LIABILITY.
354. If an unrestricted service is too costly under present con-
ditions, the question arises whether the liability could be limited.
In examining possible methods of limitation we have to weigh
the ultimate gain in the improved dental condition of the insured
people against the claim to immediate relief of those actually
suffering in health owing to neglect of the teeth. From the
medical point of view there are obvious advantages in concen-
trating on the treatment of young persons and in spending the
money on conservative work. But such a policy is not likely to
be acceptable, since it does nothing for those older persons whose
mouths are in such a condition as to produce digestive and other
disorders resulting in present suffering and, what 1s important as
an insurance consideration, consequent demands on the benefit
funds. The two conflicting points of view might possibly be
reconciled by making no charge for conservative and operative
treatment, but requiring the insured person to contribute a sub-
stantial proportion (say 50 per cent.) of the cost of dentures.
Such a proposal is open to the obvious objection that it would
tend to exclude the most necessitous of the insured population
who need dentures and who could not afford £2 or £3 towards
their provision. (See Brock, Q. 23,943.) This difficulty might,
to some extent, be met by allowing Societies some discretionary
power in cases of proved need to contribute the balance as an
additional benefit. We recognise that such discretionary benefits
are difficult to administer and are liable to abuse. But it does
not seem to us impossible to devise tests which would afford at
least a partial safegnard against administrative abuses. No
restricted service can ever be quite satisfactory, but the restrie-
tion we have suggested seems to us least open to objection.
355. An alternative method of limitation would be to make
the benefit recommendatory and to leave the selection of cases
to the Insurance Committees or their successors. on the basis