NATIONAL INSURANCE

Taranaki Daily News, 5 September 1935, Page 11

NATIONAL INSURANCE

SCHEME FOR DOMINION CAREFUL INQUIRY NECESSARY.. ENGLISH DOCTOR’S OPINION. A national health insurance scheme for New Zealand is a subject to which consideration is being given by at least two organisations, the New Zealand Farmers’ Union and the Counties’ Association, which plan to have a conference on the matter with representatives of the Hospitals’ Association. Some interesting comments on such a scheme were made at .Auckland by Dr. H. Guy Dain, chairman of the Insurance Acts Committee of the British Medical Association. Dr. Dain, who arrived at Auckland by the A.orangi on Sunday on his way to the association’s annual meeting at Melbourne, expressed the opinion that very careful local investigation would be needed before the introduction of a State health insurance scheme in New Zealand. Dr. Dain said that without knowledge of conditions in New Zealand he could no say how far the English system would be suited to the Dominion, but from inquiries which he had made on the journey across the United States he -was inclined to think that many changes would have to be made; Undoubtedly health insurance had been a great success in Britain. It provided the worker with a “family doctor service” which he had never had before. It should be remembered, however, that medical treatment was not a necessary part of a health insurance scheme. If the worker under, conditions of normal employment was able to pay ordinary private medical fees or to obtain the services of a medical man through membership in a friendly society, it should be regarded as sufficient for the health insurance scheme to provide him with sick pay. In Britain at present, and in many parts of the Continent of Europe, where health insurance was being established, a large proportion of workers were not in a position to pay such fees. Some form of direct medical benefit was therefore necessary. Such a system was necessarily expensive and required a good deal of official machinery. It was also found to interfere to some extent with the normal relations between doctor and patient. MINIMUM OF INTERFERENCE. However, the British system, in Dr. Dain’s opinion, caused less such interference than any other. The contributor was not obliged to call at an office and go through formalities. He was entitled within certain limits to choose his doctor and also to change his doctor. This allowed a good deal of elasticity and prevented the relationship from being too formal and rigid. So far as the doctor was concerned the present capitation fee, nine shillings a year for each patient, might not be considered large, but it had been fixed three times by arbitration and would no .doubt be reviewed from time to time in future. The British scheme was complicated to the extent that it included unemployment and sick pay, maternity and medical services—all in return for one stamp fastened oh the worker’s card each week. Nevertheless, it was incomplete in that it did not provide hospital or consultant services or general medical service to the worker’s wife and children under the age of 16. It was to be regarded as a first step towards a full medical service. ■ , Health insurance was making good progress on the Continent of' Europe, and it was being talked about in the United States. If it were adopted in the latter country the probability was that the medical benefit would be limited to sick pay. The provision of actual medical attendance on a nation-wide scale would be extremely difficult under a Federal system of Government. There was no Federal medical register and the laws governing registration in the various States differed very widely. In some, osteopaths, chiropractors, and other practitioners w’ho were regarded by the medical profession as unqualified were entitled to registration, and doubtless would claim the right to come under the scheme, and confusion was bound to result. In considering the establishment/ of national health insurance in countries such as New Zealand and Australia, the aim should be to provide only such services as were really necessary. What these were would depend upon the ability of the worker to pay ordinary medical fees under normal conditions of work and wages. The nature of existing hospital services and their cost to the patient and the taxpayer would also have to be taken into account. No scheme could be properly framed without the fullest investigation of local economic and other conditions. In such an investigation the medical profession should be given ample opportunity to express its views, which should be carefully weighed.