The Times WEDNESDAY, FEBRUARY 26, 1941. A Health Insurance Service

Manawatu Times, Volume 66, Issue 49, 26 February 1941, Page 6

The Times WEDNESDAY, FEBRUARY 26, 1941. A Health Insurance Service

That portion of the Social Security policy which has been gazetted to provide general practitioner benefits as from March 1 is colloquially termed “a free medical service.” Such is, of course, a misnomer; it is not a free service at all but actually an insurance service. And as with ail insurance services the worth of the policy is to be judged from the relationship of premium to return, in this case, the benefits. However pleasing a scheme may look upon paper, its real value is to be judged in a practical manner; by the actual quality of the service rendered.

The long drawn-out negotiations that have taken place between Ministers of Social Security and the doctors belonging to the British Medical Association have seen a conflict upon this aspect of the Government's proposals, rather than upon any matter of remuneration. Actually, it is understood that the Government has offered the doctors of the Dominion most generous financial reward; of such a measure indeed that the receipts of all engaged would have substantially exceeded in aggregate their past earnings. Most certainly, of course, medical men were in principle opposed to the regimentation inevitable in a nationalised and socialised medical service. But apart altogether from that, apart altogether from the personal aspect, as applying to themselves individually, they have consistently opposed the general practitioner scheme in the belief that it was contrary to the good of those whom they serve —their patients, which means the people of the Dominion. Now to-day we see an open conflict which must soon come to a head. A conflict which must be regarded as one of theory versus practice. Here is indeed an unfortunate state of affairs. The more so at a time when national unity is so greatly to be desired.

Doubtless those responsible for the general practitioner benefits plan as published last Friday, believe that something of worth has been produced. Credit is to be given for good intentions. This, even though such may have been influenced by political philosophy, the desire towards socialisation, and again from the fact that this is election year. Unfortunately, however, according to the president of the New Zealand branch of the 8.M.A., the Government had not consulted this doctors' association “any further in the details of the plan now gazetted, and the association was still entirely opposed to it.” The statement went further and told of the doctors’ determination to have nothing to do with the scheme. In view of this it appears most probable that the scheme will be a paper one only, and that is, of course, of very little use to anyone. It is greatly to be deplored that such a situation should have arisen, and may we repeat, most particularly at this time of national crisis. Not that the public need fear any such action as that of a strike and a cessation of services, such as is seen all too often when some other sections of the community are in a disgruntled frame of mind. Everyone expects and knows that medical men will carry on and not let the public down.

We have compared the proposed free medical service with an insurance scheme and that comparison does provide a light upon amendments that might be feasibly made. It is very usual when a motor-car is insured for there to be what is termed a

“franchise.” The vehicle is insured fully, but the franchise provides that the owner shall be responsible for, say, the first £2 worth of damage. This relieves the insurance administration of a vast amount of petty detail and small settlements. The insurance thus serves its real purpose—the protection from any considerable loss. Is this not what the public really wishes of a medical service? Citizens do not require free medical attention for every minor complaint or indisposition, but the great majority would keenly welcome a sickness insurance that safeguarded them against the expenses of, say, a major operation, or a long, expensive course of special treatment.

A supreme weakness to the Government's present proposal is that while the State looks after the pennies of medical expenses, it leaves the patient to find the pounds thereof. For this reason the scheme must be viewed as an unsound insurance. Citizens are not so concerned at receiving free a half-guinea visit from a doctor as at being insured against the risk of a 25 or 50-guinea operation.