THE New Zealand Herald AND DAILY SOUTHERN CROSS SATURDAY, APRIL 9, 1938 HEALTH INSURANCE

New Zealand Herald, Volume LXXV, Issue 23009, 9 April 1938, Page 14

THE New Zealand Herald AND DAILY SOUTHERN CROSS SATURDAY, APRIL 9, 1938 HEALTH INSURANCE

Health insurance has, unfortunately, taken on a restricted meaning, being identified with the type of scheme introduced in Germany in 1886 and in Britain in 1911, and now proposed by the Government for New Zealand. It does not attempt to insure good health. Rather it aims to assist people when they fall or feel sick, supplying free medical attention (but not specialist service), free medicine, and sickness benefits according to scale until they are well again. A correspondent has pointed out a higher and wider objective — one already discussed on several occasions in this column —that the question of health insurance can be approached from the angle of prevention as well as of cure. It is better to keep people lit than seek to mend them when they fall ill. In the older countries, in fact, experience has taught the limits of the original health insurance schemes. The latter have certainly been productive of much good, outweighing the bad features, such as malingering, too ready recourse to the panel doctor producing hypochondriac tendencies, addiction to the medicine bottle, and lowering of standards of general medical practice. While retaining their present insurance schemes, Germany, Britain and other countries are tending more and more to regard public health from a positive or constructive point of view. In Germany there is the "Health through Joy" movement and in Britain the National Fitness Campaign. Britain, more than any other country, is also giving close attention to the nutritional aspects of health. Proper feeding is at least as essential an element of fitness as proper exercise.

In New Zealand, of course, there should be no question of malnutrition. The standard of wages and social services is such that all should he Able to command sufficient food in the correct categories. Yet school medical officers and other authorities have left no doubt that malnutrition is widespread. The percentage of serious cases' may be low but the percentage falling short in some particular is disquietingly high. The problem does not seem, therefore, to be one of means, but of imparting the necessary housewifely knowledge to use the means to the best advantage in a nutritional sense. At least that is part of the problem. Another part may arise out of soil exhaustion or deficiency, depriving plants and animals of essential foods and minerals, a deprivation later suffered by the human consumers of fruit, cereals, vegetables, milk and meat. This fundamental lack is really the province of biological research and agricultural science, although the interest and co-operation of the Minister of Health—"the marriage of health with agriculture"—would undoubtedly stimulate progress. Allowing for this gap in the health front, it must still be admitted that much better use could be made of the available food resources, a much higher standard of nutrition achieved. The first line of defence of the nation's health runs through the home, and its strong point should be the kitchen. The mother should possess more knowledge than she generally does of the value of particular foods, and of how to prepare them so that the values are preserved. Good cooking is as important as right and balanced selection. A wide field is opened here for rational education. Money spent intelligently on its tillage would yield higher dividends in public welfare than millions poured out on free medical advice and bottles of medicine.

To provide the knowledge is not enough, however. Take it on the average, no class in this country is harder-worked and more overstrained than the mother raising a young family. She is the heart of our society, supplying its life-blood from her own. None has yet come to her assistance with a 40-hour fiveday week, or ensured that she is paid a minimum wage and given good working conditions. She suffers and often —though not if she can help it—her husband and children do too. Health insurance that leaves out this hearth and home problem ; must always be a poor thing. Education may help, but only if it is humanly possible for the mother to apply it in filling the market basket and in the kitchen. Often there is far too much for one woman to do, child-bearing and child-raising, and no help that is a help to be had. Therefore the most promising aspect of health insurance'so far discussed is that embracing proposals for training domestic workers and the establishment of a skilled domestic help service. The social as well as the health gains accruing can be imagined if the woman of the house could be raised from drudge to planner, enabled to be mother and wife as well as cook and housemaid. This part of the social security scheme should be brought to the forefront, where it belongs. It offers far more cover than the expensive and limited health insurance proposed—cover against malnutrition and the stunted and sickly lives that follow therefrom. Far better thus to insure for good health than assure people of attention when they are ill. Another constructive insurance of health consists in physical education, a subject already sufficiently canvassed in this column and made familiar by the distant echoes of the British campaign for national fitness, which has recently received the King's eloquent recommendation. Since the ~ Government's social security scheme proves still to be at the skeleton stage, public opinion could do much to direct the attention of the special Parliamentary committee and of Cabinet to these ; positive methods of health insurance, _ even at the sacrifice of the negative measures chiefly proposed.