The Evening Star WEDNESDAY, MARCH 5, 1947. COST OF SOCIAL SECURITY.

Evening Star, Issue 26042, 5 March 1947, Page 6

The Evening Star WEDNESDAY, MARCH 5, 1947. COST OF SOCIAL SECURITY.

The principles of the New Zealahd social security scheme, including, cash age, family, invalidity, sickness, and other benefits and free medicine and hospital treatment, have been emphatically endorsed at successive General Elections, but the people cannot be blind jto the fact that there are abuses, which offer considerable room for reform. Certain sections of the community have found the operation of the scheme extremely profitable, and the Government is apparently prepared to continue blissfully on its way, expanding the. services in such a way that they , promise to become the heaviest impost on t.he income of the people. This is in line with Mr Nash’s declared policy of taking as. much as. possible of the people’s money and spending it in a better, way than they could or would themselves. The weakness of his argument is, of course, that his policy does not give individuals better value for their money, but taJkes it from ,one section to give it to another that does not necessarily, nor is evenlikely, to, spend it to better advantage. However, social security has come to stay, in this country, and it should be the object of all to ensure that it is operated in the best possible way for the maximum advantage. For that reason there should be considerable interest in a new book, ‘ Health Reform in New Zealand,’ written by Mr Douglas Robb, a well-known Auckland surgeon, whose incisive criticisms are worth close attention. Reminding his readers otf- the extent to which the scheme lias been allowed to develop, Mr Robb points out that in 1939-40—the first year after its introduction—social security cost £11,231,641. Last year £31,000,00p was spent on it, and in the Estimates for 1946-47 provision is made for expenditure totalling £35,000,000. It seems that the Government is still not satisfied,_ for it has nom begun to introduce in a limited way dental benefits which will presumably apply ultimately to the whole population. The present Estimate represents an outlay equal to £2O a year for every man, woman, and child in the country, and if the cost is allowed to climb much .higher, as seems very likely, the benefits will cancel themselves out in that the impost of social'security taxation, - even on the smaller incomes, will ’ equal the monetary - advantages. It is particularly in the field of payments’ for medical treatment and medicines that the cost has advanced to an abnormal extent. Originally the Government proposed a capitation system for payment of 15s a year to doctors for all registered patients. When most of the profession resisted this plan a payment-for-services scheme was introduced, with the result _ that the popularity of the capitation system waned sharply. This year the Government has budgeted for payments to practitioners of* almost £1,500,000, which is considerably above ad average of 15s a year for each person in the country. The cost of pharmaceutical benefits is described by Mr Robb as “ staggering.” Since 1942-43, the first full year of operation, the cost has risen from £563,247 to £1,133,366 last year, and an ’ estimated £1,206,000 in the year just ending. In Parliament last year the Minister of Health admitted that the Government was concerned about the. huge cost otf the indiscriminate ordering of medicines by certain doctors who might best be described as “ prescription factories.” The department had found it necessary to warn such doctors about their casual use of costly medicines, now on the free list, but it is obvious from the Estimates that no reduction in the expense was expected. Mr Robb says that the new costly drugs, which include almost all modern hormones and synthetic and biological preparations, “ should be used much more critically by doctors, and not ordered as placebos to the importunate and neurotic, as so often happens.” This is a justifiable warning if the social security scheme is to be prevented from breaking down under its own weight. The Government has allowed costs to rise enormously in a period of general prosperity, without any consideration for the possibilities in a time of financial difficulty, when revenue .would inevitably fair and the drain on the (fund increase. As it is, the Consolidated Fund is being called to bear an . increasing share of the cost* of social security—this year it is £18,000,000, only £2.000,000 short of the estimated revenue from the levy of Is 6d in the £ on all income. The public should, therefore, remember that social security is actually costing them almost 3s in the £ of actual inpome, and they should ask themselves seriously whether they are satisfied they receive full value for the diversion of one-seventh of their aggregate earnings to this purpose. It has long since ceased to be a case of the so-called wealthy paying for benefits ifor the poor. The cost of social security has now risen so high that it lias become a heavy charge on everyone, and even 1 the most .lowly contributor cannot afford to see the money spent lavishly and wastefullv.