PUBLIC HEALTH

New Zealand Herald, Volume LXXIII, Issue 22543, 7 October 1936, Page 16

PUBLIC HEALTH

INSURANCE SCHEME INFORMATI ON SOUGHT BASIS FOR PROPOSALS EXTENSIVE QUESTIONNAIRE [ISY TELEGIIAm —SPECIAL REPORTER] WELLINGTON, Tuesday Some indication of the possible development of tho Government's policy with regard to national health insurance can bo obtained from a general questionnaire! which has been drawn up for submission to persons and organisations likely to be interested in or affected by the operation of such a scheme. Tho questionnaire, it is underStood, was approved this morning by the general committee investigating the question and copies were despatched to-day. The questionnaire, which invites comment or. specific points covering various aspects of any proposed scheme, is tc bo given wide circulation. It will bo distributed to doctors, dentists, nmses, insurance companies, friendly societies, actuaries, hospital boards and other professional individuals anc! organisations. An elaboration of views on any question is invited and ib is indicated that any phases of tho subject not covered in the questionnaire may be the subject of separate statements. Task el Great Magnitude It is also intended to arrange for the taking of oral ovidonce according to the necessity as revealed by the replies received to the questionnaire. Ib is expected that after the replies have been received on the stipulated closing date, November 30, and after oral evidence has been taken by the specially selected committee, an effort will be made to collect the moist useful views expressed on tho various aspects of the scheme and to uso them as tho foundation on which the Government's actual legislative proposals will be built for submission to Parliament next year. Naturally, the sifting of tho replies and hearing of oral evidence on such an important subject will be a task of great magnitude.

The questionnaire, a ccvpy of which was released ior publication this evening bv the Minister of Health, the Hon. P. Fraser, is subdivided under a number of main headings. In commenting on tbe nature of tho scheme, recipients of the questionnaire are invited to state whether or not it should be contributory, whether any classes of persons should be exempt from contributions, and, if so, whether minimum and maximum income limits should be applied in determining the . exemptions; Scope ol Benefits "With regard to beneficiaries, the points submitted are whether the benefits should extend to the dependants of the insured ard if so who are to be regarded as coming within that category". The question is also raised •whether any class of persons, such as old-age pensioners and unemployed, should be entitled to benefits without having contributed. Another query is whether an insured person should have his rights to benefits modified in respect of any period during which lie is in receipt of payments under the Workers' Compensation Act. . . Under the heading of benefits it is asked whether any of the following should be excluded: —General medical practitioner services, specialist and consultant services, laboratory aids, medicines and appliances, dental treatment, ophthalmic treatment and optical appliances, orthopaedic appliances, noninstitutional nursing and massage services, maternity services, hospital and sanatorium treatment, transport of patients. Sickness benefit and disablement benefit contracts and third parties are deal; with under a separate Leading. Defining 33asis o! Payment Assuming that the relative benefits are included in the scheme, information is sought as to the basis of payment for medical services classified as general practitioner, specialist and consultant, the basis of arrangement for the supply of medicines arid appliances, and the basis of payment for ophthalmic treatment and "optical appliances, and for non-institutiona!. nursing, massage and maternity services. Opinions are also invited as to the basis of payment from tho proposed fund for treatment in public hospitals and sanatoria Dn the one hand and private hospitals on tho other. There is a further request to define the basis of payment for ambulance and other transport services. A long list of questions is submitted with a bearing on administration. It is asked whether the administration of cash benefits, such as sickness or disablement benefit, should be separated from the administration of benefits in kind, such as medical and hospital benefits. . . In the matter of the central administration of the scheme the points raised are whether there should be a specially constituted central body with executive powers, with a request for an outline of its general constitution, or, alternatively, whether the national health insurance administration should bo made the function of an existing department or departments enlarged for the purpose. Other Administration Points

Other points refer to the advisability or not of having local administration undertaken by specially constituted local insurance authorities, the extent to which friendly societies and other bodies which aro already administering voluntary insurance schemes should be entrusted with responsibility under the general scheme, the provision which should be mado for consultation between administrative bodies and committees representative of those supplying services under the scheme and the principal method or methods of payment and collection of income* A final clause, asks whether income from all sources should be allocated to separate funds for certain benefits or groups of benefits and whether each such fund or the national health insurance funds as a whole should bo kept actuarily sound.

During tho past few weeks there have been some published estimates regarding tho possible cost of a national health insurance scheme. Tho range of the questionnaire itself suggests that no'reasonable estimate of cost can be made until the scope of the proposed scheme is finally determined.