SOCIAL SECURITY

Manawatu Standard, Volume LVIII, Issue 234, 1 September 1938, Page 8

SOCIAL SECURITY

s HEALTH BENEFITS. ! FARMERS AND MEDICAL , SERVICE. Per Press Association. WELLINGTON, Sept. 1. From a financial point of view a sound health insurance scheme is not open to the same objection as the pension proposals. It would not impose fresh on the community, but would be merely a rearrangement of the methods of paying for medical services. A well-designed scheme should relieve tho thrifty of some of the burden of providing medical and allied services for the thriftless who would then automatically make some provision for themselves. Thus runs an official statement by the Farmers’ Union on the Social Security Bill. A fundamental difference between the Farmers’ Union’s idea and what appears to be the idea of tho social security proposals in regard to medical benefits is that the Government desires the doctor to be the servant of the State while we desire him to be the servant of tho patient. Complete freedom of choice between doctor and patient is, in our view, a very necessary condition, and this is not secured by allowing beneficiaries to change, at prescribed times, tho doctor on whose list they are. It is not clear from the Bill that, having chosen a doctor, there is a right to change to another doctor. It is certain that if such a right oxists it can bo exercised only at certain times, which will apparently bo prescribed by tho Minister. This does not satisfy the Farmers’ Union’s idea of freedom of choice. The principle for which wo stand in this respect is apparently conceded in regard to chemists, a beneficiary being free to go to any chemist who is willing to work under tho scheme. It has also been conceded in regard to medical attention to maternity cases, and thoro seems to bo no reason why it should not bo conceded in its entirety in regard to medical services. Tho Bill makes no specific arrangements with regard to the treatment of country patients, and we submit ■ that there should bo definite provisions in the Bill to deal with the treatment of country patients, and definite provision for doctors’ travelling expenses should be set out in the Bill.

SEPARATION OF CONTROL. Wo consider it important that the administration and control of the health services should be entirely divorced from the administration and control of the pension scheme, and that it should have its own finance vested entirely in the controlling authority, the union adds. That authority should be removed from the political sphere and should consist of a board representative of the medical profession and other professions im-

mediately concerned and representative of hospital boards, and of the patients. , The Farmers’ Union has always laid stress on the insurance aspect of health insurance, and an enormous amount of detailed administration, with its attendant costs and regulations, could be avoided by giving l>eneficiarios the right to obtain lhedical aid from any duly qualified man who was registered under the scheme. The insurance scheme would pay for services of medical practitioners at an agreed-on scale of fees. This would also allow a patient who desired to do so to employ a ' medical practitioner whose services

were more costly than the agreed on rate, he, of course, hearing the extra expense. HOSPITAL FINANCE. There are many aspects of- the health proposals with which we are in agreement, but we are profoundly disappointed that no provision lias been made to deal adequately with the question of hospital finance. It seems, to bo generally assumed that the Bill'" provides a payment of 6s a day per ; occupied bed in hospitals, and it is . argued that this is considerably great- , er than the amount which Hospital. Boards are actually able to collect ' from patients at present, and to this extent is an .assistance to hospital finance. Actually there is no provision in tho Bill for the payment of any stated sum. There is, however, provision for some payment, the amount of which appears to be entirely at the discretion of t'lio Minister. A public hospital is, however, prohibited from charging a patient any fees whatever. ■ In our opinion the payment of it is on the basis mentioned and will not 'help hospital finance, as tho extra accomodation required, and the extra services will necessitate increased capital and maintenance expenditure which will more than counter-balance any assistance from tho Social Security -Fund. Wo are supported in this opinion by the executive of the Hospital Boards Association, which, according to Rev. W. C. Wood, its vice-president, “was of tho opinion that this amount (6s per bed per day) would be more than cancelled out. Provision and maintenance of additional beds would undoubtedly follow the introduction of free hospital treatment and it would also bo necessary to extend out-patients departments and to provide consultant and specialist services.' Boards would also be re- | quired to pay tho present honorary staffs, as it was perfectly obvious that honorary services could not be reconciled with free hospital treatment for all.” The position surely becomes ironical when wealthy persons availing themselves of the specialist services, such as radio and X-ray. may not be charged for services which struggling farmers must pay heavy rates to give them. EFFECT ON THE FARM. Summed up, it appears as if the medical scheme will mean that the far--mer will:— (1) Still have to pay his hospital rates. (2) Have to pay his Is in tho £ like everyone else. (3) Have to bear a large proportion of tho extra taxation required; and (4) Have his hospital rating greatly increased because of the extra capital expenditure which is bound to bo required, adds the union.