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March 16, 1940


JAMA. 1940;114(11):1005. doi:10.1001/jama.1940.02810110071023

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To the Editor:—  The industrial picture in Britain has lately been holding my attention because it is the nation whose experience with compulsory health insurance that has been presented as most worthy of being copied.Prior to the rearmament activity, Britain's unemployed were listed as approximating 2,000,000. In spite of the war's effect on employment it is said to have been 100,000 more in December 1939 than in the preceding September.Up to the time of the initiation of rearmament the recipients of the dole were estimated to be in the neighborhood of from 16 to 18 million. How are the figures relative to the unemployed to be correlated with those on the dole?Half of Britain's working population receives less than £250 ($1,250) annually. These and their dependents—again, a matter of 18 million—are the beneficiaries of her National Health Insurance. What relation have their numbers to the unemployed or to those on the dole? If the figures for those on the dole do not represent the same fraction of the population as the employed group with incomes less than £250, how, then, are their health needs met? Are they the "charity" of the profession or, if not, in what manner do they provide or is compensation provided for the physician?

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