ut,—I am in agreement with your correspondent, W. H. H.
C., that e approved societies are not responsible for the limitation of their tivities, which were defined by the Insurance Act, but that does not ter the fact that the system they represent is inefficient and costly. any district a score of societies are to be found competing for members, ch with their own offices, staffs, agents and sick visitors, the whole aking up an overlapping service. Each member of a household may, d often does, belong to a different society, and I have known two sick sitors, each from a different society, call at one house on the same day, coincidence, no doubt, but an example of the inefficiency and cost of e system. A State Department would obviate such wasteful competi- on and redundancy, the cost of which is really carried by the insured son.
For each insured person the society is allowed 5s. 6d. per annum for
nistrative purposes, and the doctor 9s. 9d. per annum for medical ice. Out of the latter sum the doctor pays the whole expense of edical service (excluding drugs), as well as his end of the clerical inistration of his panel list, no small item. What remains is his net fit, subject to Income Tax. I think that when the services rendered e compared with the sums received there seems little doubt that society inistration is expensive. At the last valuation, the reserve funds of societies amounted to scores of £ million. (From memory, I think figure was £148 million, but I cannot turn up the authority for that e, so cannot vouch for it.) I consider that any group of concerns hose combined reserves are so large, and who have one thing in
n, the financial control of a State monopoly, constitute a vested tcrest, particularly when it is considered what political pull and lobby- power financial institutions have, and that the nation's health should decided upon impartially. by Parliament, and not subjected to such terested pressure as such vested interests can exert.
But W. H. H. C. really supports my argument for a State Department hen he says that practically all the societies pay extra benefits, implying eby that some few, the weak ones, do not, which means that the ed person obtains his benefit according to actuarial incidence, ch depends on the administrative ability of his society, and not accord- to his need, a principle that I contend is indefensible. Mr. Kessler uces another strong argument for the same purpose when he points that the adolescent is denied dental benefit, as at that age he is not, rding to approved society finance, qualified for it. His need for it neglected.
To sum up, I submit that health benefits should be dispensed according social need and not according to actuarial incidence, and that this cannot until the approved societies are replaced by a State Department.—
&c., S. WRAY. The Mill House, Ingham, Lincoln.
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