NATIONAL HEALTH

Manawatu Standard, Volume LVII, Issue 197, 21 July 1937, Page 2

NATIONAL HEALTH

INSURANCE PLAN. VIEWS OP MEDICAL PROFESSION. It is too often overlooked that in national health insurance the real insurance carriers are the medical profession. The State has funds for the purpose, but its liability is defined by the amount of its funds; the liability of the profession is indeterminate. In other words, the community seeks to pass on its unknown sickness risk to the profession for a known sum. Hence caution is excusable. Thus states the New Zealand branch of the British Medical Association in the course of its plan for national health insurance, the principal features of which were published in the “Standard” yesterday. In life insurance the risk taken by the insurance carrier can be actuarily determined. In insurance against hospitalisation limits may be set and a fair computation made. But general sickness risk is an incalculable thing in unselected bodies. The basis of any figure we could suggest would be a knowledge of the work We should have to do. This knowledge is lacking. The administration of an insurance scheme should, naturally, tit into the administrative system of the Health Department as a whole, and for that reason some adjustment for correlation would be required. It may he necessary later to enter more fully into discussions on these points of relationship between the insurance plan and other branches of curative and preventive medicine, but at present the only part of the genera] administration to which we wish to refer is the Board of Health. We recommend that this board should be constituted on a mainly scientific and technical basis, and should be rapable of advising on all the various activities of the Health Department. The branch also submits the following system of administration: (1) Central administration.—-As part of the general health administration, the administration of the insurance plan would necessarily be tinder the Director-General of Health as chief executive officer of the Minister of Health. Tinder the Director-General and specifically controlling the national health insurance plan, we recommend a com missioner, who should be an overseas authority specially appointed for a period of five years to inaugurate and administer the plan. At the end of that period the administration would he ta)cen over by a Director of Medical Services under the Director-General.

The following advisory bodies should form part of the central administration : '

(a) A central comm'ttee. or committees, representing various interests, to be consulted by the authorities on all matters appertaining to their respective interests.

(b) A central medical committee, representative of the medical practitioners of the Dominion, appointed by the council of the New Zealand branch of the British Medical Association, with special representation of the faeultv of med’eine of the University of Otago, of the Royal Australasian College of burgeons, and of the proposed Australasian College of Physicians. This committee should have the right to be consulted by the Minister responsible for health services before any regulations affecting the medical practitioners of tile Dominion are promulgated. It should also be the body to which a local medical committee may refer my Question that imports a matter involving a general principle. Tt should have the right to approach the Minister directly through its chairman. or deputy appointed in his place, on anv matter affecting the medical practitioners of the Dominion. Where anv matter is referred to it hv the Minister or by any branch of the Government, adeouate time should be allowed it to consider, discuss, and report its opinion on the matter. (2) Local administration.—We recommend that districts for local administration should bq large, anil should divide the whole population into parts •is even as may be consonant with geographical features and natuval lines of communication. They should correspond generally to health districts or such rearrangement of these as mav be determined upon in the general system of health administration. The local administration should he a branch of the central administration, consisting of a local health officer and staff, to which is attached a regional medical officer.

WEIGHING THE COST. In another part of the plan it is stated: In view of the taxation charges which even a limited health insurance scheme would involve, the public should have an opportunity to weigh the cost against the assumed advantage. “It has been estimated that a universal practitioner service, and other associated services, would mean an addition to taxation of £3.500,000, equivalent to 7d to 8d in tli<* pound on all wages salary or income. This is a large burden. It would have to he assumed'immediately if that project is to he put into operation on April 1 next, as we have been assured is the intention. But there is nothing in the health condition of the country to indicate a necessity for such speedy adoption of new remedial measures at so great fiscal cost. “This association, therefore, earnestly urges that legislation should be delaved until full data are available, complete investigation has been made, and the people and their representatives have rebelled informed conclusions.”