National Insurance Health

Where an insured person is rendered incapable of work by an accident or industrial disease in respect of which he is entitled to compensation under the Workmen's Compensation Act or to damages, sickness and disablement benefits are not payable to him unless the weekly value of compensation or damages is less than that of the benefit which would ordinarily have been payable. In this case the difference only is payable by way of benefit.

An employed contributor does not cease to be insured and entitled to benefits immediately on ceasing employment but con tinues so entitled for a period between II and 2 years at the full rates of benefit, and if he can show that throughout that period he was genuinely unemployed his insurance is continued for a further year, subject, however, to reduced rates of benefit. A person who has been insured for at least io years and who becomes unemployed after reaching the age of 6o is allowed to continue in insurance (so long as he remains genuinely unemployed) until he attains the age of 65, and thus his title to a contributory old age pension is safeguarded.

Payment and Collection of Contributions.

The contribu tions are paid by means of the purchase of special stamps at any post office. The health insurance contribution is paid jointly with the contribution payable under the State scheme of con tributory widows', orphans' and old age pensions, by means of a single health insurance and pensions stamp to the amount of the joint contribution. One of these stamps has to be affixed to the insured person's contribution card in respect of each week of employment, but special arrangements may be made in certain cases for stamping in bulk. It is the duty of every insured person to obtain a contribution card at the beginning of each contribution period and to present the card to his employer to be stamped at the proper times. The contribution period is a period of six months commencing on the first Monday in January and July of each year. If an insured person fails to produce a contribution card to his employer to be stamped at the proper time, the employer is required to stamp an emergency card, which can be obtained at any post office. The money for health insurance received at post offices from the sale of health insurance stamps is paid into a fund known as the National Health Insurance Fund, which (in England) is under the control of the Minister of Health and out of which all the moneys required for the payment of health insurance benefits and the cost of their administration is supplied.

Medical Benefit.—The arrangements for the administration of medical benefit are on a territorial basis and are made through special bodies, known as Insurance Committees, in every county and county borough. These committees are composed, as to a majority, of representatives of the insured persons in the area, the remaining members being representative of doctors or nomi nated by public authorities. It is the duty of the insurance com mittee to prepare a panel of all the doctors in the area of the committee who desire to treat insured persons, and any registered medical practitioner has the right to have his name placed upon the panel. The insured person has free choice of the insurance practitioner from whom,he is to receive treatment. The insurance practitioner enters into an agreement with the insurance corn mittee, by which he undertakes to provide to all insured persons on his list any medical treatment (within the competence of a general practitioner) which they may require at any time and to prescribe for them such medicines as may be necessary. In return for his services he is paid at the rate (since 1924) of 9s.od. a year for every insured person on his list. In addition to this capitation payment doctors in rural areas receive a supple mentary mileage allowance in respect of additional cost of travelling. The insured person can obtain the medicines pre scribed for him by his doctor from any chemist taking part in the service. A further obligation of the insurance practitioner is to supply the insured persons on his list with such medical certifi cates of incapacity for work as they may require in order to make good their claims to sickness and disablement benefits. The total charge on insurance funds to meet the cost of medical benefit and its administration is limited by the Act to i3s.od. per insured person per annum.