THE NEED FOR HEALTH INSURANCE

Fisher, Irving

The Need For Health Insurance By IRVING FISHER Professor of Economics at Yale, and a Leading Authority on Public Health AT PRESENT the United States has the tin-enviable distinction of being the...

...To-day the Standard Oil Company has granted those same workers in its Consfablo Hook plant the very increase in wages which they had demanded...
...Just as employers have installed safe guards for dangerous machinery in order to reduce the cost of Workmen's Compensation, so in order to reduce the cost of Health Insurance they will supply better sanitation, ventilation and lighting, more -physiological hours of labor, one day's rest in seven and fuller consideration for the special needs of employed women and children...
...I REGARD war as tne greatest curse ot mankind— that it has done more to retard the progress of the race and its material well-being than any other single cause.—Henry Ford...
...The war has for a time withdrawn much of the world's labor supply and destroyed and maimed a large part of that which it has withdrawn...
...At present the American workmen without Health Insurance are gambling with their livelihood and in millions of cases are sure to be thrown out of the game...
...If Standard Oil is uniting to give its workers better wages, as their master and overlord, Standard Oil will do it...
...It is more economical to pay a little premium for fire insurance each year than to suffer a big loss when the fire comes...
...Tlie corporation admits that what the men demanded was right...
...It is not a question of average well-being but of the numbers diverging from the average...
...The other is that any loss from sickness is a far more vital matter to them than to the rich...
...It will employ gunmen against them, and pervert the police power of the state to its own lawless uses...
...In order that it shall function properly it needs must be universal and in order to be universal, it must be obligatory...
...The national Convention of Insurance Commissioners in their examination of tho fourteen principal companies writing industrial Health and Accident Insurance found that the ratio of losses-showed that the policy holders spent a dollar to receive back a benefit of between thirty and forty-six cents...
...They must not try to gain by collective action and collective bargaining even the most reasonable advantages...
...Moreover, tho cash benefit gives the workman a better chance for recovery as well as a more perfect recovery if attained...
...AS IMPORTANT as Is indemnification, it is far less important than prevention...
...It is also true that millions of American workmen cannot at present avail themselves of necessary medical, surgical and nursing aid...
...for, to the poor, the obstacles to recovery are largely economic,—insufficient food or other necessaries, worry over making both ends meet and the consequent necessity of a premature return to work while still-half-sick...
...After some fifteen years' study of the preventabil-ity of sickness, 1 am convinced that the great virtue of Health Insurance, for decades, perhaps for centuries, to come, will lie in the prevention of illness...
...It has constituted an important part of the policy and career of some of Europe's greatest statesmen, including Bismark and Jjloyd George...
...Present insurance facilities in the United States are and, so far as we can see, always Will be hopelessly inadequate...
...I believe it to be a correct economic portent that the world is about to enter upon a period of life conservation...
...There is the need of indemnification against loss and the need of diminishing the loss itself...
...They must not seek to control their own lives...
...If they do, Standard Oil will beat them up and shoot them if necessary...
...HEALTH INSURANCE Is like elementary education...
...They must not organize among themselves or attempt to organize...
...There are special reasons to hope that Health Insurance may win favor rapidly...
...Sidney Webb, that 'In all countries, at all ages, it is sickness to which the greatest bulk of destitution is immediately due''" Finally we may expect health insurance, when properly adratnistercd, to help forward industrial peace, for it will create machinery for continual conference between employers and employees...
...The Armstrong Investigating Committee (1906) received testimony from one of the largest of the industrial insurance companies to the effect that one-third of the policies lapse within three months, one-half within a year and two-thirds within five years...
...For a generation the enlightened nations of Europe have one after another discussed the idea and followed discussion by adoption...
...These figures are in striking contrast to the results of the compulsory system abroad...
...Students of gambling condemn games of chanco bocause sooner or later most gamblers must lose enough to throw them out of the game...
...There has never been a better picture of what "wage slavery" means than this latest Standard Oil proceeding...
...According to an officer ot the United States Public Health Service, assigned to the Commission on Industrial Relations, sickness produces seven times as much destitution as industrial accidents...
...in its Constable Hook Plant in Bnyonne, New Jersey, was terrorizing, shooting and killing its workers who had asked for an increase in wages and who had gone on strike to enforce their demands...
...Too superintendent of insurance of the District of Columbia reports that the people who pay Health Insurance premiums to agents who collect ten, fifteen and twenty-five cents a week at the' homes ot policy holders "have to give up one dollar for every forty cents they get back...
...The world will seek the greatest possible salvage out of the wreck...
...In health insurance, as in...
...When a poor man becomes sick, unless he can tide the emergency'over by insurance or otherwise, be runs the risk of getting "down and out," for he has no margin...
...Tho .war has made labor scarce and therefore dear...
...One is that the worker is more likely to lose his health than the capitalist for it is well known from several lines of research that the death rate, and therefore the sickness rate, prevailing among the poor is from two to three times that prevailing among the well-to-do...
...BUT prevention of disease and disability is not the only prevention to be effected by Health Insurance...
...Fewer working men will be thrown on the scrap heap in their forties with all the tragic consequences to their families as well as to themselves...
...Without Health Insurance a vast numbor sooner or later exhaust their margin and sink into poverty—a land from whoso boum few travellers return...
...This fact will not only make for high wages but also for the conservation of labor...
...Under the compulsory system there could be no lapses...
...These estimates are doubtless over-conservative...
...In addition to the primary advantage of universality, there are incidental advantages in the compulsory system...
...There are important economics in administration owing to the elimination of the cost of collection, the cost of advertising and the other costs of securing business as well as in the elimination of lapses, and of a large actuarial reserve in in-Tested funds...
...There is no other measure now before the pnbllo which equals the power of Health Insurance toward social regeneration...
...Again, under compulsory health insurance both employer and employee will co-operate with the general public in securing better public water suiiply, better sewage systems, better milk,-mcat-and-food laws, better school hygiene, more playgrounds and parks, and proper regulation of liquor and other other destroying businesses...
...The Need For Health Insurance By IRVING FISHER Professor of Economics at Yale, and a Leading Authority on Public Health AT PRESENT the United States has the tin-enviable distinction of being the only great industrial nation without universal Health Insurance...
...Standard Oil and the other Rockefeller interests and the Steel Corporation and the similar corporate employers of labor have granted such increases of wages as they have granted partly because their self interest demands that their workers get enough to eat to keep them able to work...
...Their "crime" for which the Standard Oil was ready to inflict the death penalty irresponsibly, was in daring to demand that right and to get together to enforce it...
...Freedom By DANTE BARTON SOME time ago the Standard Oil Company...
...Her wonderful industrial progress since that time, her comparative freedom from poverty, reduction in the death rate, advancement in hygiene, and the physical preparedness of her soldiery are presumably due, in considerable measure, to Health In-wrance...
...and Mrs...
...Wage Slavery" in Action Philanthropy vs...
...even in England where the cost of administration is high because of the supposed necessity of utilizing preexisting friendly societies, the administrative costs amount to only 14 per cent Under the voluntary system the policy is apt to lapse just when it is most important that it should not...
...The workers.have won their strike...
...But the curious and melancholy fact is that the poor in this country, have received, as yet, very little benefit from the application of the Insurance principle outside of workmen's compensation...
...Yet it is the poor whose need of Health Insurance is greatest, and for two important reasons...
...At least 42 per cent, of the deaths now occurring in the United States are unnecessary, or over 630,000 lives could be saved annually by applying existing and known methods of life saving which would add at least fifteen years to the average duration of human life...
...It will indirectly but powerfully tend to reduce poverty...
...The employee, on the other hand, will be likewise stimulated to utilize and apply factory hygiene, domestic hygiene and individual hygiene...
...THE NEED of Health Insurance, like that of most other forms of insurance is twofold...
...It is by the compelling hand of the law that society secures liberation from the evils of crime, vice, ignorance, accidents, unemployment, invalidity and disease...
...But the Standard Oil wants them to feel that they are "wage slaves...
...This act was the first step in her program of social legislation...
...The worker who loses his health loses his chief asset...
...One important effect of such attention to the health of the workman will be the prolongation of his life and especially of its earning period...
...Health Insurance will afford a very powerful and pervasive stimulus to employers, employees and public men to take fuller and Bpeedler advantage of possible health-saving devices...
...According to the logic of those now shedding crocodile tears over health insurance we ought, in order to remain truly American and truly free retain the precious liberties of our people to be illiterate, to suffer accidents without indemnification, as well as to be sick without indemnification...
...education, we are dealing not with obligatory burdens but with obligatory benefits...
...Germany showed the way in 1883 under the leadership of Bismark...
...As the Brief for Health Insurance of the Amsriran Association for Labor Legislation says and as the above statistics would indicate, "America evidently presents uo exception to the finding of Mr...
...Certain Interests which would be, or think they would be, adversely affected by Health Insurance have made tho specious plea that it is an un-American interference with liberty...
...But partly and chiefly they "voluntar-ily" grant the better scales in order to head off the exercise by the workers of their power to compel better wages and better conditions by the union organization which is able to keep the advantages that it once gains...
...They forgot that compulsory education, though at first opposed on these very grounds, is highly Amorican and highly libcrative...
...The Health movement can be far more potent than the Safety movement because sickness is more prevalent and more preventable than accidents...

Vol. 9 • January 1917 • No. 1


 
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