The chief justification of a national system of insurance against sickness is that it shall be an active auxiliary in the prevention of disease. At present it is doubtful whether any national system of sickness insurance has been so. It has only been so, to the extent to which the medical treatment of the masses of the population has been improved by it; and no such improvement can be claimed for British insurance. The wider possibilities of prevention of illness and elevation of the general standard of health, by making each medical practitioner a family adviser on health more than a practitioner in medicine, have not been realised or even brought within sight. _Evils of the Present Medical Benefit_ The inadequacy and unscientific character of the medical treatment given to insured persons are associated with a large amount of lax certification of illness, which is injurious to the character of doctor and patient, besides being unfair to the insurance funds. Those interested in this point should read paragraphs 118, 119, 120, 121, 123, 125 of the Report of the Departmental Committee on Sickness Benefit Claims (Official Report Cd 7687). There is almost universal testimony of the belief (of representatives of friendly societies) that medical certificates are granted recklessly (par. 119). Doctors ... feel a difficulty in refusing certificates owing to the possible effect upon their practice.... If a doctor falls out with his patient he loses the entire family (par. 120). These statements ... are representative of an enormous volume of dissatisfaction with the action of the medical profession. The Committee state: We are of opinion that in many cases doctors have given certificates for sickness benefit in circumstances in which these certificates were not justified. From the standpoint of the conscientious practitioner the present position is profoundly unsatisfactory. He has no official access to arrangements for consultative and expert advice, he has no hospital beds, no skilled nurses. For the patient the position is anomalous and leaves him with but a fragment of what he could reasonably expect under the terms of the Act.