HEALTH INSURANCE

Evening Star, Issue 22735, 24 August 1937, Page 13

HEALTH INSURANCE

THE PROFESSIONAL VIEW ADDRESS BY DR NEWLANDS Members of the faculty oft insurance were addressed last night by Dr W. Newlauds, who spoke on the subject of national health insurance, referring to the professional attitude toward such proposals. Ho emphasised the importance of avoiding any hasty step to put into effect such a scheme, and the need for the public to be made cognisant of the various aspects of the subject prior to the introduction of any proposal in Parliament. There was a large attendance at tlie meeting, which was presided over by Mr W. W. Johnstone (president of the faculty). National health insurance, Dr Newlands said, was a subject very much to the fore at the present time, although the public was still largely in the dark about what was going to happen or likely to happen in the near future. At the last election both the leading political parties had included a national health insurance cheme in their manifestoes. What the public would have to see was assured was a workable scheme which would give an adequate service in return for the considerable amount of money which would be involved. It was necessary that any such scheme should not be entered upon hastily, and Now Zealand was the one country in the world in which haste was quite unnecessary, as there were in existence so many facilities which gave a service so little short of satisfactory that there was no need to take a leap in the dark. A Government committee had been very busy taking evidence, but the view of the medical profession was that this committee was not th% ; best qualified which could have been appointed. Also, there did not seem to be any great assurance that the findings of_ the committee would he adopted if they conflicted with political policy. Accordingly, in an endeavour to give public opinion something to work upon, and in response to a request from the Government Investigation Committee, Jhc British Medical Association had established a committee which had published a plan recently. This plan, Dr Newlands said, could bo regarded as the limit to which the profession was prepared to go. NATIONAL HEALTH PROVISIONS. It could be regarded as a universally accepted truth that the health of the population of any country was its most important consideration; and in the past 100 years the Governments of all civilised countries had devoted much time and money in promoting public health. Every country now possessed a central health department, with extensive central and local administrative machinery. Sanitation, factory, and similar legislative enactments, pure food Acts, housing, control

Aof infectious diseases, quarantine laws, and numerous others had been initiated and improved with unceasing -. olfort. Also vital statistics had been elaborated which established the scientific basis of facts on which all real progress in. hygiene and health pro notion rested. Besides these national provisions for public health.'.there were those more concerned with the individual or the family group. These were_ largely educational, and included the instruction of the individual in what was beneficial or harmful ifi everyday life, such, as eating and drinking, ventilation, exercise, persona! cleanliness, avoidance of risk of infection or disease from other human beings, from animals, plants, etc. Next to ho noted were the numerous agencies concerned in the cure or alleviation of disease and accident when occurring; not only the medical, nursing, and allied professions, hospitals, asylums, and ' rest homes, but many societies such as the St. John Ambulance, the lied Cross, the Crippled Children Society, the Plunket Society, the sick benefit societies, and the great organisations known as the friendly societies. Every church, too, including the Salvation Army, had developed extensive social services. The Dominion was well provided with all these numerous agencies, which were liberally supported by the public, and they rendered very worthy service. The medical and nursing professions in New Zealand were probably amongst the most highly trained and the moat efficient in the world; and the tradition of honorary service had lived strongly down to the present, though of recent years there were not wanting signs that its era of honourable and useful service ivas likely to terminate. Professional charges were mostly very moderate —not above wdiat they had been for the past 50 years or more, Private hospital fees could ho favourably compared with English fees. DRASTIC REFORM UNNECESSARY. It could bo regarded as indisputable fee said* (that |here MfrS W>. urgent

reason for hasty or drastic reform. . At the same time the profession held, and had frequently stated, its conviction that there should he more facilities available to the less well-oS portion of the community to what could be called the “indigent and nearindigent.” This did not apply to hospii tal services, for this was available to them already, full and free. The proportion of hospital beds to population in New Zealand was among the highest known. It did apply to domiciliary treatment. The professional attitude was that medical and allied service should be made available to every member of the community; if the patient was unable to pay for it he should not be asked to pay. If he was able to pay then he should be expected to do so. This was practically the position in regard to public hospitals, and it could surely be extended to domiciliary service at reasonable cost, and without any elaborate machinery. It was to the credit of the present Government that it had recognised the problem as one requiring solution; the difficulty was that in its hurry and inexperience it might attempt too much and in wrong directions. The British' Medical Association Committee had studied the position in many other countries, and it had had several consultations with the special committee set up by the Government, with Dr D. G. M'Millan as chairman. It was unfortunate that this committee’s position and authority were of so indeterminate a character. The outcome had been the decision of the associa-' tion to formulate and publish a plan embracing the utmost length the profession was prepared to go towards meeting what it conceived to be the Government’s policy or likely policy. THE PROFESSIONAL ATTITUDE. Dr Newlands said he believed that it was the purpose of the Government to establish a universal scheme under which all would have the right to individual treatment without financial consideration, although just how this was to be done had not yet been stated. In many European countries

there was in operation some attempt to formulate, such a scheme. In News Zealand the profession was quite prepared to help along a scheme to give adequate and honest sick treatment of all kinds to the classes which could not get it when the need arose—a scheme by which this would be their right and. 1 not a'charity. Under the association’s plan the population had been’ divided into four sections, and, of these, two,: which would require either to be provided for by some national scheme, op to be partly provided for under some insurance against major illnesses, comprised about 66 per cent, of the total population. It was ielt, that these proposals fully met all the demands: of the situation in New Zealand, and it was believed to be practicable and workable, although it would bo costly. The association had. expressly refrained, from any estimate of cost, as that was not its province. It had also to the field of medical benefits, • excluding the cognate question of cash benefits* though fully cognisant of the importance of these benefits, especially in the case of long incapacity of the ■ breadwinners where financial anxiety often proved a deterrent to seeking and undergoing proper treatment, and had equally often militated against the recovery of a patient. Speaking as a representative member of the medical profession, Dr Newlands said they did not want a national* health insurance scheme which had anything to. do with any approved society,. but on© conducted by a speciallyappointed board on which the profession would be adequately represented. They wanted to avoid any sacrifice of professional freedom such as .would bo involved if they became something in t the nature of a whole-time State servant. The profession also _ preferred, that any scheme would provide recompense for all services rendered, and would not be worked on any capitation basis. At the conclusion of the address Dr Newlands answered a number of ques- . . tions on the subject, and was given a* hearty vote of thanks*