NATIONAL HEALTH INSURANCE

Dominion, Volume 30, Issue 10, 7 October 1936, Page 10

NATIONAL HEALTH INSURANCE

Development of Plan

A QUESTIONNAIRE CIRCULATED Comment Invited Some indication of the possible development of the Government’s policy with regard to national health insurance can be obtained from a general questionnaire which has been drawn up for submission to persons and or ganisations likely to be interested in or affected bv the operation of such a scheme. The questionnaire, it is understood, was approved yesterday morning by the general committee investigating the question, and copies were sent out during the day. The questionnaire, which invites comment on specific points covering au. aspects of any proposed scheme, is to lx? given wide circulation. It will be distributed to doctors, dentists, nurses insurance companies, friendly societies, actuaries, hospital boards, and other professional individuals and organisations. An elaboration of views on any question is invited, and it is indicated that any phases of the subject not covered in the questionnaire may be the subject of separate statements. It is also intended to arrange for the taking of oral evidence according to the necessity as revealed by the replies received to the questionnaire.

It is expected that after the replies have been received on the stipulated closing date of November 30, and after oral evidence has been taken by the specially-selected committee, an effort will be made to collect the most useful views expressed on the various aspects of the scheme and to use them as the foundation on which the Government s actual legislative proposals will be built for submission to Parliament next year. The work of sifting the replies and hearing oral evidence on such an important subject will be a task of great magnitude. The questionnaire, a copy of which was released for publication last evening by the Minister of Health, Hon. P. Fraser, is subdivided under several main headings. In commenting on the nature of the scheme, recipients of the questionnaire are invited to state whether or not. it should be contributory, whether any classes of persons should be exempt from contributions, and, if so, whether minimum or maximum income limits should be applied In determining the exemptions. Rango of Benefits. With regard to beneficiaries, the points submitted are whether the benefits should extend to the dependants of the insured and, if so, who are to be regarded as coming within that category. The question is also raised whether any class of person, such as old-age pensioners and unemployed, should be entitled to benefits without having contributed. Another query is whether an insured pers6n should have his rights to benefits modified in reji spect of any period during which he is in receipt of payments under the Workers’ Compensation Act. Under the heading of benefits, it is asked whether any of the following should be excluded:—General medical practitioner Services, specialist and consultant services, laboratory aids, medicines and appliances, dental treatment, ophthalmic treatment and optical appliances, orthopaedic appliances, nontnstitutional nursing and massage services, maternity services, hospital and sanatorium treatment, transport of patients, sickness benefit and disablement benefit. Contracts and third parties are dealt with under a separate heading. Assuming that the relative benefits are included in the scheme, information is sought aS to the basis of payment for medical services, classified as general practitioner, specialist and consultant; the basis of arrangement for the supply of medicines and appliances; the basis of payment for ophthalmic treatment and optical appliances and for non-institutional nursing massage and maternity , services. Opinions are also Invited as to the basis of payment from the proposed fund for treatment in public hospitals and aanatoria on the one hand and private hospitals on the other, and there is a further request to define the basis of payment for ambulance and other transport services. Administration of Scheme.

A long list of questions is submitted with a bearing on administration, xt is asked whether the administration of cash benefits, such as sickness or disablement benefit, should be separated from the administration of benefits in kind, such as medical and hospital benefits. In the matter of the central administration of the scheme, the points raised are whether there should be a specially constituted central body with executive powers, with a request for an outline of its general constitution or, alternatively, whether the National Health Insurance Adminis tratlon should be made the function of an existing department or departments enlarged for the purpose. Other points refer to the advisability of having local administration under taken by specially constituted local insurance authorities; the extent to which friendly societies and other bodies which are already administer ing voluhtary insurance schemes should be entrusted with responsibility under the general scheme: the provision which should lie made for consultation between administrative bodies and committees representative of those supplying services under the scheme, the principal method or methods of payment and collection of income. A final clause asks whether incoms from all sources should be allocated to separate funds for certain benefits or groups of benefits and whetner each such fund or the National Health Insurance Fund as a whole should be kept actuarially sound. During the past few weeks _ there have been some published estimates regarding the possible cost of a Na tional Health Insurance Scheme. The range of the questionairre itself suggests that no reasonable estimate of cost can bo made until the scope of the proposed scheme is finally determined