HEALTH INSURANCE PROPOSALS

Dominion, Volume 31, Issue 278, 20 August 1938, Page 13

HEALTH INSURANCE PROPOSALS

Further Criticism By

B.M.A.

PREVENTION BETTER THAN CURE

The failure of the Government in its health insurance proposals to make any provision or improvement in the general health of the people, on the principle that prevention is better than cure, is emphasised in a further statement issued yesterday by the New Zealand Branch of the British Medical Association.

Following up its representations in which it urged that the Government would have been far better advised to have given attention to environmental conditions, nutrition, prophylactic or preventive methods, and research, the association draws special attention to the question of administration. ‘‘ln regard to matters of administration,” it states, ‘‘the view the association takes that national health insurance Is a system invented over fifty years ago to meet difficulties in other countries which to a large extent have been overcome in New Zealand by following lines and methods of our own. The health insurance system involves a complicated administration of its own; and if we superimpose upon our own health administration this borrowed system, a cumbrous structure will result. We consider that it would lie wiser before introducing national health insurance to review and amend the existing administrative machinery which has developed in an irregular manner during the rapid changes of a century’s growth and settlement. Responsibilities Scattered.

‘‘An important point is that present health responsibilities are scattered among so many departments and unrelated bodies that departmental control must be exceedingly difficult.

“There are also too few health districts and too many hospital districts. For 30 years this association has supported proposals for the reform of hospitals and health administration. Hospital districts should be large enough to enable all hospital and health activities to be co-ordinated in a district relationship, so that the local health interests should be related to the department through its district health officer. There is urgent need for provision of satisfactory central control of all hospital activities throughout the country. This control is desirable and necessary in the matter of new hospital buildings; in deciding on different types of hospital accommodation; in the training of administrative and professional officers; in the method of appointment of professional staffs so as to ensure that the best medical talent in the district may be available in, the hospital; in the provision of special institutions such as, say, cancer hospitals and tuberculosis sanatoria. “It is necessary in such system of control .to understand the special position of the metropolitan hospitals on account of their geographical position and the additional duty of medical., education with which they are now charged. Into such reorganisation the admiinstration of an insurance system, if and when adopted, would naturally fall. We arc aware of the great difficulties surrounding such reform, but think it a necessary prelude to any further addition to our system, if complication, and .even confusion, is to be avoided. Representations Ignored.

“These are matters which require extensive inquiry and discussion. They have been represented to the Government by the association as being urgently necessary, but, so far from having taken any notice, the Government has completely ignored them. Instead, it has preferred to go ahead with its own proposals which, although involving vast cost and possible disruption of the economic structure of the country, cannot effect any improvement in the general health of the people. “This, at first blush, may appear to be a startling 1 statement to make. It is, however, based on the irrefutable fact that the Government does not propose to provide any more for the health of the people than is provided at present, and has preferred, to eject the association’s proposals, which would have effected a substantial improvement.”