The title of the act—National (Health) Insurance Act—has hitherto proved a misnomer. The panel or contract system of medical treatment of insured persons has done much to continue the obsession of the public with the conception of medical care as consisting of a “visit and a bottle”; and so long as the doctor’s medical work is on the present basis, and he is under the constant temptation, not only to accept more patients on his panel than he can satisfactorily treat and to give each patient on application the mental satisfaction of a “bottle,” but also to be more than lenient in the giving of sickness certificates, it will remain questionable whether on the balance state insurance against sickness does more good than harm. If medical consultants and referees, treatment centres, and hospitals are in the future provided for insured patients, this will mitigate the evils of the panel system; but the present contributions of patients will not purchase this additional provision. All the new money needed, and most of the money needed under present conditions, must continue to be provided by the state and employers of the insured (a form of taxation); and provisions thus made, like the present contributions of the state for insured persons, are in direct contravention of the general principle that government grants being derived from the whole community, should enure to the benefit of the whole community in need of them, and not only to the benefit of a section of it. About one-third of the total population of Great Britain is included within the terms of the National Insurance Act. If the wives and children of insured men were also included, as has been proposed, over two-thirds of the total population would be embraced in the scheme; but as persons manually employed, but working for themselves—e.g., cotters and hawkers, are encluded, and as persons not manually employed cannot be insured unless their income is below £160 (recently raised to £250), large classes of the population who can ill-afford to pay for their own medical attendance are excluded from the operation of the act, and taxed to pay the benefits of insured persons.