HEALTH INSURANCE

Manawatu Standard, Volume LVII, Issue 212, 7 August 1937, Page 10

HEALTH INSURANCE

DOMINION SCHEME OPPOSED. HASTINGS DOCTOR’S SPEECH

HASTINGS, Aug. 6. A statement that the medical profession objected to the national health insurance scheme on the grounds that it would be harmful to the health or the people generally and quite an unnecessary tax on everybody was made by Dr. Roland Caslimore, president or the Hastings branch of the British Medical Association to-day, while addressing Rotarians. Dr. Caslimore said most medical men were opposed to the national scheme, but agreed there were sections of the community which should receive assistance. He contended that the proposed Government scheme would cost far more than estimated by the Government and the money would be better spent on preventing disease, pointing out that at the present time more than the estimated cost of the scheme was spent on fruit and trees. “The medical profession feels the public has no conception of the magnitude of the scheme nor the effects it will have,” Dr. Caslimore said. “We are more or less in favour of national health insurance, but we advocate a different scheme from that proposed by the Government. We are the ones who should know better than the politicians what is best.” £1 A HEAD A YEAR.

Under the scheme proposed the Government would impose a tax on all, entitling everybody to free medical attention. It was not from any financial consideration that the doctors did not favour the scheme, as the doctors had been offered more than they were getting at the present time. They would get one pound a head a year on the whole population of New Zealand which would' mean a total amount something like £1,500,000, but the doctors would not accept it. They objected on principle. The population, )r. Caslimore contended, should not be taxed. There were, however, three groups which should be covered. They were : (1) Old-age pensioners, unemployed, unemployables, people with an income of not more than the amount of the old-age pension. These people, Dr. Caslimore pointed out, already received free medical attention simply because they could not pay for it, but there was no acceptance of this fact: they had to suffer loss of dignity. Hospitals billed all people alike. The result was that people in this group fell mto two classes —those who would call a doctor at all hours and take advantage of him and those whp would not call a doctor until it was too late. (2) Single > jbn, women with an income of not more than three pounds a week and married couples without children receiving not more than tour pounds a week, with an allowance of an additional ten shillings a week for each child under 16 years. (3) People with an income of £oUU a year or under not included in groups 1 or 2. People in this grout) were usually nlile to pay their doctor s hills, but protracted illnesses frequently ran up hospital bills which took away as much as a quarter of a man’s annual income. These people, therefore, needed help for hospital and . nursing expenses. People with annual incomes in excess of £soo—there wore not so many of these—were able to look after themselves, Dr. Cashmore said. Tf they so desired, of course, they should lie allowed to link up with the scheme voluntarily. IMMENSE COST.

A universal scheme of health insurance like that now proposed had never been tried in any other country. It was going to cost New Zealand an immense sum. The Government had suggested it would cost £3,500,000 a year, but it had been estimated by the hospital boards that the gross medical services amounted to four times the amount necessary for paying the doctors. If the doctors were to be paid the amount now offered them, the total cost of the scheme would he £6,000,000. If this was raised by a tax on income as the Government intended, it would mean 7d off tho weekly wages in addition to present taxes. Dr. Cashmore said that the medical profession was sincere when it opposed the scheme. Though they were'offered more financially, they were more concerned with the preservation of the health of the people. World-renowned medical men had repeatedly said that in Australia and New Zealand a type of medical practitioner and hospital service not found anywhere else in the world had been evolved. PANEL SYSTEM.

“I said hospital service,” said Dr. Cashmore, “not the system of control by hospital boards, which is bad.” Under the panel system people attended doctors frequently, something between 30 and 40 times a year or more, but the New Zealand average was about nine or 10 visits. In a busy day a doctor saw about 20 to 25 people a day, but if the number increased to 50 or 60 the result would be that patients would get less attention. Dr. Cashmore contended that the panel system encouraged a doctor to be less thorough, for the element of competition was removed. “We believe the scheme to be harmful and unnecessary. We feel the money to be spent on it could bo better spent on diseaso prevention and public health work,” he said. “The number of lives saved every time a small epidemic was nipped in the bud must run into hundreds. We are spending far more on saving fruit and trees than on disease prevention. We object to the proposed experiment and think that a universal scheme is detrimental to the health of the country.” Dr. Cashmore said that under the proposed scheme it would not pay a doctor to spend a great deal of tipie and money on research and study because it would bo of no advantage to him to do so. It was certain that the Government w,ould not worry about sending doctors to England for tramin" Dr. Cashmore said that many doctors would get out of the country and would not work under the Government’s system. Most doctors were against the system, and said that practically onlv the “needy and greedy would fall for the system. In the event of doctors refusing to work under the scheme, Dr. Cashmore said that tho Government’s alternative would be to import men. “There are plenty of Jewish doctors being turned out of Germany and some English doctors might be willing to work for a fixed wage. There would not he a free choice of doctors under the scheme. This is a form of individualism the Government is against, he said. “Tho Government held that the State nnd not the patient should choose the doctor.” Dr. Cashmore also said that the scheme would eventually lend to the socialisation of chemists and lawyers. The Government was starting on the medical profession because it was the smallest body.