CHAPTER IV
Insurance and Health[11]
So far as a majority of the population are concerned, it is necessary to realize that they are never far removed from the line dividing destitution from adequacy, using the word destitution to mean insufficiency or lack of some provision essential for health and continued welfare.
It may be urged that this is owing in large measure to the improvidence or thriftlessness of the wage-earners who are chiefly concerned; but such a statement fails to appreciate the higher standard of conduct and the greater self-denial which is demanded from weekly wage-earners than from ourselves, if out of their wages provision is to be made for a “rainy day,” without affecting unfavourably the present health of the worker or his family.
The general appreciation of the above considerations has led to the provision of non-contributory old-age pensions in the United Kingdom; and similar sentiments have led in many countries to compensation for accidents at the expense of employers; and to the various national systems of insurance against sickness. With the principle of sickness insurance there can be no quarrel. It is the substitution of coöperative for individual provision, thereby distributing some of the loss and eliminating some of the risk of suffering from illness.
The value of any system of sickness insurance, however, must necessarily be judged by several criteria.
Criteria of Value of Insurance
Is the adopted system one which is equitable in its incidence and economical in its administration; and does it supply maintenance during sickness adequate for the needs of the patient and his family, while at the same time offering no temptation to the patient to continue on the sick funds, when his condition no longer necessitates this?
In the case of the English National Insurance Act, these questions unfortunately cannot be answered completely in the affirmative.
The finance of the Act arranges for the uniform contributions (differing for each sex) from some thirteen million persons, living under most diverse conditions, to furnish equal benefits (differing for each sex) to all insured persons, irrespective of age, locality, or occupations; while at the same time some 23,000 independent insurance societies continue to administer the distribution of money benefits, each with its own segregated experience, some prosperous, others owing to excessive sickness almost bankrupt. There is the remote possibility for each society to pay additional benefits if justified on the quinquennial valuation.
Substantially men and women have been placed on a similar financial basis. The sickness of pregnancy apparently was overlooked; and for this and other reasons the insurance funds for women are financially inadequate for the benefits promised.