National Health

Manawatu Times, Volume 61, Issue 10, 13 January 1936, Page 10

National Health

BENEFITS OF INSURANCE ..... ... SCHEME.

(Written for the “ Times.”)

Tlio question of a national health in suranco scheme for New Zealand is one that is receiving considerable attention at the present time. In addition to the consideration given by various political parties, a number of associations, are. showing considerable interest, the. Hospitals Association, the Counties Association, the 8.M.A., the N.Z. Friendly.Bocieties ’ Association, and the New Zealand Farmers’ Union being numbered, among those who • recently discussed,,the matter in conference. The subject- of sickness insurance is one m which.; practically every civilised country, at some time or another, has displayed considerable interest. Bismarck introduced national health insurance in

Germany in 1883, and finally it extended all oyer Europe, where it has found well nigh universal acceptance. There are to-day some 20 countries, mainly European,, in which a system of compulsory insurance is in force for the benefit, of wage earners. The. full list of

these is v as follows: Austria, Bulgaria, Chile, Czecho-Slovakia, Estonia, France, Germany,: Greece, Hungary, Irish Free (State, Ja pan, Latvia, Lithuania, Luxemburg, Netherlands, Norway, Poland, Roumania, United Kingdom, Union of Soviet Republics and Yugo-Slavia. In addition keen interest has been shown in health insurance in both Australia and South' Africa, where it has been the subject of investigation by Royal Commissions, and again in Canada, where .-the-,.Canadian Medical Association is engaged in promoting a scheme and has brought down a plan embodying its views on the matter.

Sickness insurance is based on the idea of giving the workers greater economic security and peace of mind. It has been-described as having three function,s-r-firstly; provision of means of subsistence to replace the . earnings which cease with sickness; secondly, the .restoration to health and full working capacity where illness has occurred; and prevention or the reduction of damage resulting from avoidable disease. , In its origin, insurance aimed at. providing the sick with benefits in kind -to replace the wages which they were unable to earn. Little by little this idea has yielded to a wider and more genuinely social conception which makes the restoration of the patient the first consideration. Benefits intended to restore the health of the patient begin to overtake cash benefits. Medical aid, which consisted hitherto of a rapid consultation with the insurance doctor, becomes more ample, and improves. ■ Drugs, which are an indispensible complement of medical treatment, are supplied at the cost of insurance. Hospital treatment may be substituted for consultation with, or visits by a doctor, and becomes an ordinary benefit. In countries -where medical aid is organised by insurance more or less collectively, the' advice and attention of specialists are made available for insured persons. Such dental treatment as may bo necessary is also generally provided by insurance. Special kinds of treatment, baths, and residence in convalescent homes enable the cure of the insured persons to bo completed under the same conditions as that of the rich. Again, insurance is interested in the prevention of sickness. It realises that it is better to prevent than to cure and that a vigilant preventive policy can avoid the loss of productive capacity, and increase the material, intellectual and moral well-being of the community.'

Belief, cure and prevention, then, are the three-fold functions of sickness insurance; In the beginning, the emphasis was on relief; at present it is on cure, but .in insurance schemes of the future undoubtedly it will be on prevention! .National scheines for sickness insurance vary in detail according to local conditions, but a certain measure of uniformity is found in respect of the following points: A very definite tendency for sickness insurance to be compulsory rather than voluntary; a tendency for it to be limited to the class of wage earners; a tendency to widen...its benefits to include the whole of the medical aid which is necessary for the insured or his dependents; a tendency to find the money necessary to finance sickness insurance from insured persons, employers and public authorities; a tendency to entrust the control of insurance to institutions with a territorial basis, in the management of which insured persons have increased participation.

Sickness insurance was originally developed on a voluntary basis, but, with one solitary exception, i.e., Denmark, voluntary methods have proved unsuccessful and have been replaced by compulsory methods. It is true that in Denmark, voluntary insurance has proved. adequate, but in that country, although insurance is described as optional, there are indirect penalties attaching to failure to insure. Thus, if a man becomes a charge on the State, he loses his. right to vote, he cannot marry without. the consent of the authorities, and, if he has received relief during the three preceding years, he. forfeits his claim to. an old age pension. The difference , then, in Denmark, between freedom of choice and compulsion is somewhat tenuous. The principle of the workers ’ contribution has been accepted in all countries except Soviet Eussia. The principle of the employers’ contribution.is likewise accepted in all countries except Roumania, and in a part ot' Switzerland where the scope of insurance includes non-wage-earners. On the other hand, a contribution from the State is less usual, and where granted, varies widely both in character and amount. It may take the form of a fraction, of the total contribution, a subsidy for each person insured, a share in the cost of certain benefits, principally maternity benefits, or benefits in the form of family allowance. The proposals for a compulsory sickness insurance scheme for New Zealand are in accord with world ideas, and so, presumably, are on sound lines. National health,, insurance is an approved method for providing medical service for the bulk of the people, and its success may' be gauged from the fact that in no country in which a system of

health insurance has been adopted, has any movement arisen to abolish it. On the contrary, the tendency is to seek fo: an extension of its benefits.