of 1 /1
616 A SCHEME OF MIDDLE-CLASS INSURANCE. A SCHEME of insurance has just been proposed which is likely to reduce the anxieties of illness for the middle-class family. There is no need again to point out that there is a most important class of the community which has in sickness neither the support of riches nor of the State. It is sufficiently obvious. Practically all the contributory hospital schemes restrict their benefits to those of fairly small income, and as the costs of more complicated medical methods grow larger they form an increasingly formidable sword of Damocles which in suspension whitens the hair and in falling may wreck the home. To insure each member of a family singly against the possi- bility of disease, in such a way as to cover all medical fees and nursing, is practically impossible for the average man with a small income. Moreover, although a person insured for 26 per week-at a premium of perhaps 26 per annum-may be entitled to claim 230 for disablement by an illness requiring operative treatment, the expense of the operation itself may be as much as 100-200. The Family Medical Services, Ltd., has issued at Manchester a scheme intended to appeal to middle-class householders who have felt this difficulty. The proposers have the support and advice of Sir William Milligan, and the Association itself has no interest financially in the results of the insurance, which is necessarily specu- lative in an untried field like this. The policies are underwritten at Lloyd’s, so that the security is unimpeachable, and, in contrast to those of some mutual associations which pay benefit only if funds permit, the policies of the Family Medical Services will be definite contracts. Two schemes are issued, the first of which covers only general practitioners’ fees, and the second covers, in addition, specialists’ fees and operation expenses. It is an essential feature of the scheme that the interests of the underwriters and the insured should be identical, so that the first few pounds paid out in fees, and one-fifth of the operation costs, are borne by the latter. All members of a family residing at home who are eligible must be offered for insurance, and the premiums charged vary, of course, with the number in the family and with the scale of fees and operation charges insured against. No insurance is accepted at any age over 50 at entry, and no child is included of less than 2 years old. At other ages below 12 and above 40 the pre- miums are larger, and there are certain excepted illnesses including those not common to both sexes ; but these are merely the reservations. The benefits are undoubted. The rates charged mean that the average man can secure the services of his own general practitioner, subject to certain conditions, at from 3-kd. to 9. a week per member of his family, and can cover four-fifths of the expenses of possible operations for a further 3d. to 9d. a week. The cost of the minor yet expensive surgery which corrects smaller defects in children, and is not so much vital as advisable, will also be defrayed under this scheme, and this will probably cause the householder to look less gloomily on such interference. The issue of such policies, indeed, seems calculated to lighten a real burden. No medical examination is required, and it is only to be hoped that the terms are not so generous that they will have to be modified. PRESERVATIVES IN FOODS. THE opponents of the new Ministry of Health Regulations, prohibiting the use of all preservatives except two specified chemicals under rigidly defined conditions, are still dissatisfied and are not only carrying out an active campaign in some of our daily papers, but are proposing to take up the question in Parliament and endeavour to obtain a modification of these regulations. In particular, persistent efforts are being made to represent the boron group of preservatives as both harmless and necessary-like the domestic cat. The subject is of great practical importance, so we make no apology for returning to it and considering the grounds upon which it is suggested the regulations should be modified. These seem to be three in number : that there is inadequate evidence that the boron preservatives are prejudicial; that their elimination will send up the price of many foods in which they are now used ; and that their suppression will cause a great increase in " food poisoning." . As regards the harmfulness of boric acid and its salts, there is a respectable body of evidence that when they are present in considerable quantity harm may result from their consumption, and the Depart- mental Committee on the Use of Preservatives, after carefully considering the evidence, came to a definite opinion on the subject. It is really beside the point to assert that the small quantities necessary for preserva- tion have not been shown to be harmful, since experi- ence has shown that these limits are not maintained, and when the salts are widely used they may be consumed almost daily in a number of articles, thus giving a considerable dose of a substance which is comparatively slowly excreted. The real point at, issue, however, is that the use of preservatives is a substitute for cleanliness, and that their addition allows food to be collected, prepared, or stored under conditions which are prejudicial to health. The methods used are only practicable because the added preservative prevents the food decomposing, as it otherwise would under these unhygienic conditions. Their immediate suppression would no doubt dislocate trade and so cause a temporary rise in prices, but this point has not been overlooked in the regulations, which do not come into force immediately, not, in fact, until 1927. Scientific investigators are unanimous that cold storage is a preservative greatly superior to added chemicals and that it can with advantage to public health replace them. There is no trustworthy evidence that such a change will cause a general increase in cost, although certain special types of food may be affected. The suggestion that the suppression of preservatives will cause an increase of food poisoning is hard to understand, for there does not appear to be a single argument to support it. Presumably the idea is that without preservatives more food will be eaten in a tainted condition, since there will be so much more food of this character thrown upon the market. The use of cleanliness and cold storage instead of chemical additions will probably diminish the quantity of food showing early decomposition changes, since the general effect will be a much higher standard of purity. This view shows a singular lack of appreciation of the cause of food poisoning, which has nothing whatever to do with tainted food, but is a definite infection of the food with specific bacilli belonging to the Salmonella and other groups. There is no evidence that boric acid or other chemical preservative has a selective action on these bacilli and will prevent this develop- ment, except in so far as their general action is antiseptic. On the other hand, the prevailing factor in the causation of these outbreaks is a defective standard of cleanliness and care of the food which has allowed the specific bacilli to gain access to it and contaminate it. A heightened standard of cleanliness is one of our most important preventive measures. THE Royal Society of Medicine will hold its first social evening of the session at 1, Wimpole-street, London, W. 1, on Tuesday, Oct. 27th. MALTON : A HOSPITAL FOR 66 PARISHES.—For the last 20 years the little town of Malton, in the North Riding, has possessed an inadequate cottage hospital housed in a converted private residence. A new building is now about to be erected upon an elevated site given by Earl Fitzwilliam, with larger accommodation and better facilities for dealing with the cases that come in from the 66 parishes in the district of which Malton is the centre, many of which at present have to be sent to Leeds. The new Malton, Norton and District Cottage Hospital will have a large operating theatre with the necessary annexes and an X ray room.

A SCHEME OF MIDDLE-CLASS INSURANCE

  • Upload
    phamque

  • View
    219

  • Download
    4

Embed Size (px)

Citation preview

Page 1: A SCHEME OF MIDDLE-CLASS INSURANCE

616

A SCHEME OF MIDDLE-CLASS INSURANCE.

A SCHEME of insurance has just been proposedwhich is likely to reduce the anxieties of illness forthe middle-class family. There is no need again topoint out that there is a most important class of thecommunity which has in sickness neither the supportof riches nor of the State. It is sufficiently obvious.Practically all the contributory hospital schemesrestrict their benefits to those of fairly small income,and as the costs of more complicated medical methodsgrow larger they form an increasingly formidablesword of Damocles which in suspension whitens thehair and in falling may wreck the home. To insureeach member of a family singly against the possi-bility of disease, in such a way as to cover all medicalfees and nursing, is practically impossible for the

average man with a small income. Moreover, althougha person insured for 26 per week-at a premium ofperhaps 26 per annum-may be entitled to claim230 for disablement by an illness requiring operativetreatment, the expense of the operation itself maybe as much as 100-200. The Family MedicalServices, Ltd., has issued at Manchester a schemeintended to appeal to middle-class householders whohave felt this difficulty. The proposers have thesupport and advice of Sir William Milligan, and theAssociation itself has no interest financially in theresults of the insurance, which is necessarily specu-lative in an untried field like this. The policies areunderwritten at Lloyd’s, so that the security isunimpeachable, and, in contrast to those of somemutual associations which pay benefit only if fundspermit, the policies of the Family Medical Serviceswill be definite contracts. Two schemes are issued,the first of which covers only general practitioners’fees, and the second covers, in addition, specialists’fees and operation expenses. It is an essential featureof the scheme that the interests of the underwritersand the insured should be identical, so that the firstfew pounds paid out in fees, and one-fifth of theoperation costs, are borne by the latter. All membersof a family residing at home who are eligible mustbe offered for insurance, and the premiums chargedvary, of course, with the number in the family andwith the scale of fees and operation charges insuredagainst. No insurance is accepted at any age over 50at entry, and no child is included of less than 2 yearsold. At other ages below 12 and above 40 the pre-miums are larger, and there are certain exceptedillnesses including those not common to both sexes ;but these are merely the reservations. The benefitsare undoubted. The rates charged mean that theaverage man can secure the services of his owngeneral practitioner, subject to certain conditions, atfrom 3-kd. to 9. a week per member of his family,and can cover four-fifths of the expenses of possibleoperations for a further 3d. to 9d. a week. The costof the minor yet expensive surgery which correctssmaller defects in children, and is not so much vitalas advisable, will also be defrayed under this scheme,and this will probably cause the householder to lookless gloomily on such interference. The issue of suchpolicies, indeed, seems calculated to lighten a realburden. No medical examination is required, andit is only to be hoped that the terms are not sogenerous that they will have to be modified.

PRESERVATIVES IN FOODS.THE opponents of the new Ministry of Health

Regulations, prohibiting the use of all preservativesexcept two specified chemicals under rigidly definedconditions, are still dissatisfied and are not onlycarrying out an active campaign in some of our dailypapers, but are proposing to take up the question inParliament and endeavour to obtain a modificationof these regulations. In particular, persistent effortsare being made to represent the boron group of

preservatives as both harmless and necessary-likethe domestic cat. The subject is of great practicalimportance, so we make no apology for returning to

it and considering the grounds upon which it issuggested the regulations should be modified. Theseseem to be three in number : that there is inadequateevidence that the boron preservatives are prejudicial;that their elimination will send up the price of manyfoods in which they are now used ; and that theirsuppression will cause a great increase in " foodpoisoning." .

As regards the harmfulness of boric acid and itssalts, there is a respectable body of evidence thatwhen they are present in considerable quantity harmmay result from their consumption, and the Depart-mental Committee on the Use of Preservatives, aftercarefully considering the evidence, came to a definiteopinion on the subject. It is really beside the point toassert that the small quantities necessary for preserva-tion have not been shown to be harmful, since experi-ence has shown that these limits are not maintained,and when the salts are widely used they may beconsumed almost daily in a number of articles, thusgiving a considerable dose of a substance which iscomparatively slowly excreted. The real point at,issue, however, is that the use of preservatives is asubstitute for cleanliness, and that their additionallows food to be collected, prepared, or stored underconditions which are prejudicial to health. Themethods used are only practicable because the addedpreservative prevents the food decomposing, as itotherwise would under these unhygienic conditions.Their immediate suppression would no doubt dislocatetrade and so cause a temporary rise in prices, but thispoint has not been overlooked in the regulations,which do not come into force immediately, not, in fact,until 1927. Scientific investigators are unanimous thatcold storage is a preservative greatly superior toadded chemicals and that it can with advantage topublic health replace them. There is no trustworthyevidence that such a change will cause a generalincrease in cost, although certain special types of foodmay be affected.The suggestion that the suppression of preservatives

will cause an increase of food poisoning is hard tounderstand, for there does not appear to be a singleargument to support it. Presumably the idea is thatwithout preservatives more food will be eaten in atainted condition, since there will be so much morefood of this character thrown upon the market. Theuse of cleanliness and cold storage instead of chemicaladditions will probably diminish the quantity of foodshowing early decomposition changes, since the generaleffect will be a much higher standard of purity. Thisview shows a singular lack of appreciation of the causeof food poisoning, which has nothing whatever to dowith tainted food, but is a definite infection of thefood with specific bacilli belonging to the Salmonellaand other groups. There is no evidence that boricacid or other chemical preservative has a selectiveaction on these bacilli and will prevent this develop-ment, except in so far as their general action isantiseptic. On the other hand, the prevailing factor inthe causation of these outbreaks is a defective standardof cleanliness and care of the food which has allowedthe specific bacilli to gain access to it and contaminateit. A heightened standard of cleanliness is one of ourmost important preventive measures.

THE Royal Society of Medicine will hold its firstsocial evening of the session at 1, Wimpole-street,London, W. 1, on Tuesday, Oct. 27th.

MALTON : A HOSPITAL FOR 66 PARISHES.—For thelast 20 years the little town of Malton, in the North Riding,has possessed an inadequate cottage hospital housed in aconverted private residence. A new building is now aboutto be erected upon an elevated site given by Earl Fitzwilliam,with larger accommodation and better facilities for dealingwith the cases that come in from the 66 parishes in thedistrict of which Malton is the centre, many of which atpresent have to be sent to Leeds. The new Malton, Nortonand District Cottage Hospital will have a large operatingtheatre with the necessary annexes and an X ray room.