National Insurance Health

There are three main differences between the schemes in force in European countries and the British scheme. In the first place, while in Great Britain the contributions and benefits are on a flat rate, in other countries they are graded in accordance with the wages of the insured workers. Again, in Great Britain the weekly payments to the insured while incapacitated for work through ill ness are continued in the form of disablement benefit without any time limit of ter the maximum period of sickness benefit has been exhausted, but in the continental schemes the payments cease after a period, usually of 26 weeks but shorter in some countries and longer in others, and the insured person, if still remaining incapable of work, is not entitled to any further payment under the sickness insurance scheme. He may, however, then become entitled to relief under the scheme of invalidity pensions, which is separately administered, either as an independent scheme or in conjunction with the State scheme of old age pensions. Finally, in contrast to the British system of approved societies as agencies for the administration of the cash benefits, the insurance institu tions in continental countries are in general organized on either a territorial or an occupational basis, or both.

International Conference on Sickness Insurance.

An In ternational Labour Conference on Sickness Insurance was held at Geneva in 1927 under the auspices of the League of Nations. Delegates from 43 countries were present and the arrangements for sickness insurance in each of these countries were passed under review. As a result the conference adopted a convention with regard to sickness insurance which was remitted for ratification to all the States members of the League. The scheme outlined in this convention was similar in all essentials to that in force in Great Britain. All countries which ratify the convention pledge

themselves to set up a compulsory scheme of sickness insurance applicable both to manual and non-manual workers, deriving its income from contributions by workers and their employers, and providing medical attendance for the insured workers, together with cash payments in compensation for loss of wages through sickness. The International Labour Office reports that up to 1938 eleven nations had ratified the convention providing for a system of compulsory sickness insurance.

BIBLIOGRAPHY.-The whole of the statutory provisions with regard to national health insurance in Great Britain is to be found in the Statutes, Regulations and Orders relating to National Health Insur ance, published by H.M. Stationery Office. The best critical review of the scheme is contained in the Report of the Royal Commission on National Health Insurance, Cmd. 2596 of 1926. Much interesting information with regard to the financial and actuarial aspects of the scheme is to be found in the Report by the Government Actuary on the Second Valuation of Approved Societies, Cmd. 2785 of 1927, and in National Health Insurance, a Statistical Review, Watson, J.R.S.S., Vol. 90, Part 3. For comparative statements of the schemes in differ ent European countries, reference should be made to various publica tions of the International Labour Office, Geneva, and in particular to General Problems of Social Insurance, Studies and Reports, Series M. No. 1, 1925 and Compulsory Sickness Insurance, Studies and Reports, Series M. No. 6, 1927. Miller, Social Insurance in the United States (1918) and Morgan, Public Relief of Sickness (1923). (E. HA. ; X.)