The Birmingham age-herald., 1913-06-22


poorly paid workers, the employees
contribution is smaller and the en-
ployers greater but the total charge
throughout is is cents. In return for
this the state undertakes to provide
free doctoring and medicine III case
of sickness and to pay the insured per-
son $3.50 week in case of men and
little less than so in the case of
women during illness. Free sanatorium
treatment for consumption is also pro-
vided and a maternity benefit of $3.50
is paid to insured mothers and the
wives of insured men,
The United States and the British
domnions beyond the sea are watching
the working of the law with the keenest
interest and If it pans out" anything
like as we'll as its author, Lloyd George
dreamed, no doubt ii will be tried on
millions of other folk in the next few
years.
The immediate effect of the law was
muddle of appalling proportions, such
as is perhaps inevitable with any big
scheme which is entirely new and for
the working of which there Is no expe-
rience available. This muddle is now
being followed by general irrita-
'ioi, iCittltu III the recent DarIa-
mentary bye-election at Newmarket
which resulted in an overwhelming de-
feat for the government candidate. But
We English don't take comfortably to
new procedures. 1t irritates and con-
fuses us not to be running on smooth
Well worn tracks; so the present irri-
tation over compulsory insurance
doesn't necessarily mean that the law
isn't going to shake down, with some
cutting and Gttipp
to a garment worth copying. In fact,
the government has already taken
alarm and Mr.. Asquith, the prime min
lister, has announced that it will be
drastically amended in the light of the
experience of it's first six months work.
ing.
1t must be remembered, too, that
the opposition has come from the most
vocal and noisy class in the community,
the middle class employers who write
to newspapers; the big manufacturers
who lecture their employees on the
menace to prosperity contained in the
tax of cents a week which they
have to pay and-z7at first-the doctors,
on whom, of course, depended the sue
cessful working of the act.
There isn't the slightest doubt that
Lloyd-George made a tactical mistake
In his handling of the doctors The
English medical man Is a very pompous
person, full of dignity of his profession
and he dislikes intensely the idea of
being brigaded into what is practically
state medical service. He wouldn't
have said word If he had been allowed
to arrange the details himself, but
Lloyd-George went ahead and produced
his bill without consulting the doctors
and then adopted the take it or leave
it, altitude. The doctors declared that
they would leave It," The pay offered
wasn't high enough. the control of lay
officials was degrading, the work
couldn't be done and SO on. The Brit
ish Medical association organized a
boycott of the law and until within a
few weeks of its coming into operation,
practically every doctor in the Kingdom
was pledged not to take service under
It, There were long and tedious nego-
tiations, however. and eventually the
doctors agreed to work it. They OBJ
tanned substantial concessions. They
now receive $1.60 year for each pa
tient on their lists, which is about so
cents better than they were getting
by private arrangements from their
club and society practice, and they get
extra allowances for maternity work,
operations, etc. They also obtain in
creased representation on thel ocal gov
erning committees.
AS a matter of fact the insurance
act has turned out an excellent thing
for the doctors. and the first result ap-
parent Is a rush of new medical stu
dents. All the medical schools report
an increase of anywhere from 10 to so
per cent, and before the act the number
of students was steadily falling off. 1t
Is estimated that each doctor can give
adequate treatment to about 1000 in
surance act patients-of course, he only
sees few of them each year. A very
simple sum In arithmetic shows that
this means an average income of $4,000
a year per doctor to say nothing of his
earnings from his private practice
among patients above the SIS week
mark. Considering that the avera ge
income of English doctors before the
act was less than $500 a year, the
doctors haven't done so badly for them
selves. And above all, they are rid of
bad debts and the immense amount of
charity work that they had to do be-
fore.
The act had hardly been working a
week before 1t was revealed that Eng
land was ridiculously short of doctors,
in the working class .districts.-