HEALTH INSURANCE

Otago Daily Times, Issue 23204, 31 May 1937, Page 8

HEALTH INSURANCE

" There is no question whatever but that national health insurance and pensions legislation will be brought down and completed next session," declared the Acting Prime Minister a few weeks ago.' It was announced some considerable time ago that two committees had been set up by the Government to consider respectively the national health and insurance aspects. It is to be surmised that they are both still deep in their deliberations. It is a very large question, as they have no doubt discovered, with which they are dealing. So far the Government has given no indication of the nature of its health insurance scheme. It is apparently engaged even now upon something in the semblance of a fishing expedition in the hope that it may be provided with a satisfactory backbone for its scheme. It is a little doubtful whether the views of the medical profession will afford it the kind of encouragement and basis for procedure which it may desire. A statement made at Christchurch by Dr Duncan Stout, as president of the New Zealand branch of the British Medical Association, would appear to be based on the assumption that the Government proposes to introduce what is known as the panel system, as it obtains in Great Britain, though the Government has certainly divulged no information to the public that it has any such intention. The panel system seems to operate quite satisfactorily in the Old Country, but it does not follow that it would work equally well in this Dominion. The circumstances of population and medical service in the 'two countries provide no very useful parallel. In New Zealand the ratio of doctors to population is higher than it is in most*" countries in the world. It must be difficult, therefore, to argue that the onus is upon the Government to make provision against any lack of medical attention for the population as a whole. The hospitals throughout the country are available to the people whatever their circumstances; the activities of friendly societies enable many people of moderate or small means to secure regular medical attention at a very reasonable cost; and it is well known that, apart from their work in the hospitals, members of the medical profession render a large amount of gratuitous service to those in need of it. Therefore the deficiency to be provided against in settled communities cannot be very impressive. A difficulty arises, no doubt, in country districts where the services of medical practitioners are not so readily accessible and where the fact that doctors may have to travel very long distances to attend cases tends necessarily to make the cost of medical service high. There are country practices in New Zealand which, because of the unattractive conditions of the work they entail, are not sought after by doctors. In such cases a Government subsidy would no doubt be beneficial. In expressing views concerning a health insurance scheme more or less reflecting those entertained by the medical profession in the Dominion, Dr Stout has emphasised the necessity of a cautious approach to such an undertaking. He has suggested that a start should be made by giving a complete and highly efficient service to those in the Dominion who are unable to secure it at presentnamely, the indigent—and that from that point there might be evolutionary development bringing in those who, while able to procure satisfactory medical attention, may be unable to make adequate financial provision against prolonged illness. If it is the general medical view, as Dr Stout implies, that it is a real need of the country at the present time that a full and complete medical service should be provided for those who are classified as the indigent, the Government can hardly do otherwise than give heed to it. On the other hand it is understood to be a comprehensive scheme that it is bent upon introducing—one involving the building up of a medical service on a fresh national basis. However it proceeds, there will be dangers of which it must take cognisance. Dr Stout ha? justly emphasised. on behalf of the profession he represents, the importance of

the maintenance of the standard of medical practice and ethics. Any scheme, however theoretically ideal it might be, that would lower this standard would inevitably lead to a poor type of medical service to the community. The medical profession is naturally anxious that no precipitate action should be taken that would be calculated to do more harm than good by the production of a result that would be so unfortunate.