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. On the point of equity, it must be admitted that any system of so-called insurance which, like that of the English Act, excludes a large proportion of the population who, while paying in taxes in aid of the insured, require but do not receive their benefits, is contrary to the principle that any expenditure of Government funds should enure to the whole community in need of the provision in question. The provision of 10 shillings a week for incapacity lasting 26 weeks (7s. 6d for women), followed by 5s. a week disablement benefit, although inadequate provision for family maintenance during sickness undoubtedly is helpful. It is mischievous when in consequence of this provision, the patient is tempted to remain at home under unsatisfactory domiciliary treatment, instead of receiving the shorter and more successful institutional treatment, which should have been given. As to economy of administration, I can speak only with reserve; but it requires little imagination to appreciate that the numerous migrations of wage-earners imply great difficulties in book-keeping as well as in securing insurance medical attendance, and that a very high percentage of the total insurance funds is swallowed up in elaborate and meticulous account keeping. The point as to malingering can best be considered in connection with a discussion of the _Medical Benefit_ This consists of such medical treatment, at home or at the office of the panel doctor,[12] as “can consistently with the best interests of the patient be properly undertaken by a practitioner of ordinary professional competence and skill.”