Public health and insurance: American addressesNewsholme, Arthur, Sir
History
Public health and insurance: American addresses
Newsholme, Arthur, Sir
Health insurance -- Great Britain; Public health; Public health -- Great Britain
One can admire the optimism, while denying the accuracy of the first
statement: of the second statement, as it refers to the State of
New York, I can say nothing, except that a statement identical with
the one denied above would be literally true for England. In 1907
I wrote, “the coexistent but uncoördinated systems of treatment
of disease have failed lamentably to provide what the health of
the community requires—means for ensuring effectively the early
recognition and proper treatment of all disease” (_British Medical
Journal_, Sept. 14, ’07). That remains broadly true, and no remedy
will suffice which does not ensure for every member of the community
in essential particulars as good treatment as the most favored now
possess.
The socialization of medicine has gone too far, its beneficent
effects are becoming too well appreciated, to render it possible,
even were it not undesirable and mischievous, to hinder its further
extension. We have travelled more than half the road towards the goal
of general provision of skilled medical assistance by coöperative
means, i.e., out of the communal purse. If this is desirable for
elementary general education, it is even more important when the aim
is the restoration and the maintenance of the highest attainable
level of health for each member of the community, who is willing
to share in the offered benefits. If we include the third of the
total population who now receive in Great Britain the unsatisfactory
medical benefit under the National (Health) Insurance Act, and
remember the rapidly increasing scope of voluntary and official
institutional treatment of disease, hesitation in accepting the
inevitable should be replaced by a determination to guide future
developments and to render them efficient and economical. What is
good for the public is good also for the members of the medical
profession.
If asked to advise on the steps which it is advisable to take in
regard to Sickness Insurance in a community which has not adopted
a scheme, I should emphasise the prior necessity for the State to
secure a completely satisfactory system of public medical care before
engaging in the more difficult task of providing monetary payments
in sickness. It is well to bear in mind that medical attendance is
a form of communal assistance the demand for which does not tend
to increase with the supply; whereas monetary benefits have always
shown this trend, as demonstrated by the experience of both Friendly
Societies and charitable agencies. As satisfactory administration
of monetary benefits during sickness depends on securing medical
certification which is above suspicion, it is fundamentally important
that under any method of public medical attendance the certification
(for incapacity to work) should be completely independent of any
coexistent system of sickness insurance.
Public-domain text, read in full here on John Shaqi.
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