Any inclination to accept testimony not fully supported that the German insurance has relieved the poor law is reduced by the fact that it needs but a careful consideration of the problem to see that a scheme of insurance, especially of compulsory insurance, can easily lead, not to a diminution of poor law charges, but to an increase. And I think that in German insurance adequate precautions are not taken against some of the dangers. 1. Malingering may be increased and the dependants of the malingerer, and ultimately the malingerer himself, may become a charge on the poor law. 2. The general average standard of health may be reduced. Unless there are proper safeguards, there is manifest danger in a compulsory scheme that the congenital "bad risk," the man or woman who for some reason or other suffers from some congenital defect which leads to frequent illness, will be favoured to the detriment of the community in general, and especially of the working classes. Any scheme should contain special provision respecting "bad risks." 3. Men may more readily surrender to sickness. They may cease work for some minor ailment when they would be just as well off, perhaps better, if they continued to work. 4. Further, they may fall easier victims to "imaginary" diseases, or to gross exaggeration of actual ailments, not in order deliberately to deceive, but simply because of mental weakness or obsession. There is always danger in emphasising agencies for the cure of defects, if these defects are in any way conditioned by mind. A recent critic of German insurance, who himself was formerly a high official in the insurance service, refers to "annuity hysteria, one of the saddest results of our insurance system." He appears to have primarily in mind the accident insurance, but the same fundamental criticism applies, though perhaps in less measure, to other forms of insurance. There is clear danger, that is, that unless proper precautions are taken an insurance scheme may reduce both the physical and the mental resistance to disease, with grievous injury to the general well-being of the workman. 5. Further, in any compulsory scheme of insurance, the minimum compulsory benefits must necessarily be low, since the low-waged worker has to be brought within the scheme. There is danger that the well-paid worker will rest content with the minimum benefits which are provided. It is desirable that there should be stimulus to adequate provision. The dangers are formidable, and some may ask whether they do not condemn all insurance schemes. By no means. Under modern conditions, insurance in some form or other is not only of immense advantage to the workman, but is of cardinal importance. The discreet extension of insurance is undoubtedly one of the most urgent needs of the time, and he who boldly grapples with the problem shows the instinct of true statesmanship. No scheme can be wrought in which the dangers will not lurk to some extent. But they can be minimised. A well-devised and soundly administered system should certainly improve the general standard of health and reduce poverty. But unless sagacious precautions are taken, it may be found after all that Erewhon, with its treatment of sickness as a crime and of the patient as one to be cast into darkness, possessed the more efficient, and in the ultimate the more humane, system.1 Denmark. Remarkable results have been achieved in Denmark in the way of sickness insurance, and I had hoped to have included in the text some references to what have been done there and some comparisons of German and Danish experience. But it has not been possible to do this in the space available. The following are some brief particulars respecting Danish sickness insurance. Number of persons insured (1909), 626,000, of whom 322,000 were women. Population of Denmark, about 2 millions. Number of associations, nearly 1,500. Law providing for state aid was passed in 1892. In 1893, number of insured who came under the law was 117,000. Insurance voluntary. Effected through local, self-governing associations, under supervision of a central department. Associations must not accept as benefit-members persons with incomes or property above certain amounts. Persons suffering from chronic sickness may be accepted as members provided that benefit is not to be paid in respect of this chronic sickness. Contributions are fixed by the associations, subject to the approval of the central department. The state pays two crowns (about 28. 3d.) per member, and in addition an amount equal to one-fifth of his contribution; the total state subsidy comes on the average to a little under one-half of the contributions of the insured. Local authorities may contribute, and some do so to a small extent. More important, so far as the local authorities are concerned, are provisions in the law requiring that all the hospitals of the state, departments and communes shall treat patients at a cost not exceeding one-half that ordinarily charged, and, in the case of rural communes, that the local authority shall pay, when necessary, the cost of the transport of a patient to the doctor or to a hospital. Insured persons may also receive public assistance, up to a certain limit, without its being accounted poor law 1 This article was prepared before the Government's scheme was disclosed on the 4th May last. It is interesting to note that endeavour has been made in the scheme to avoid some of the pitfalls of German insurance. relief, if they have exhausted their benefit and are still in need. Employers do not contribute. Benefit must be provided for at least thirteen weeks 8 year. Medical attendance has to be given in kind, but medicine, surgical appliances, &c., need not be. The authorities favour a system by which the association only pays part of the cost of drugs, &c., the rest being paid by the patient; this is considered to be a check on improper claims. Insurance entitles a man to medical attendance for children under 15-an important provision. The insurance scheme is said to have much stimulated the provision of hospitals by local authorities. The associations are generally small. But federal associations have been formed for some purposes, and are playing an important part in the work. A central society has been formed for reinsuring part of the risks and thus equalising the burden. The general administration of the scheme is under the Minister of the Interior. The main work of supervision and guidance falls on the Inspector of the insurance associations, with the assistance of a committee consisting of elected representatives of insured members. In addition, larger numbers of representatives of the associations and of the central authority meet periodically and discuss insurance matters. The organisation of the scheme is, therefore, essentially democratic. Nearly £350,000 was paid in benefit in 1909, over 60 per cent. being for medical services of various kinds, including hospital treatment, drugs, &c. I. G. GIBBON P No. 82.-VOL. XXI UNDEREMPLOYMENT AND THE MOBILITY OF LABOUR. PROBABLY everyone who is engaged in any form of social work must be personally acquainted with a considerable number of artisans who have been driven from a skilled to an unskilled trade through the pressure of economic forces. In some cases it may have been due to the introduction of new machinery, in other cases to the competition of women's or children's labour, or to a diminution in the demand for the particular articles which they once made. But so far little or nothing has been done to examine the question scientifically, and it is impossible to estimate with any degree of accuracy the extent of these displacements. In the absence of any direct statistical evidence, we have attempted to utilise the results of the census reports of 1891 and 1901 to throw light upon two questions. In the first place, to what extent do men change their industrial careers under the pressure of competition, and, secondly, how far have such displacements any direct connection with the problem of unemployment? Not unnaturally, the Census reports have been rarely utilised in England in connection with the problem of unemployment, for the Census takes no account of a man being out of work, but puts him down under the occupation at which he was last employed. But both Mr. Charles Booth and Mr. Beveridge have made use of the Census reports to throw light upon the changes in industrial careers of workmen at different periods of their lives. Unfortunately they have been content to base their conclusions upon the result of a single Census, in the case of Mr. Booth that of 1891, and in the case of Mr. Beveridge that of 1901. But an examination of Mr. Beveridge's methods will show the inadequacy of both these investigations. Mr. Beveridge has taken the total number of occupied males between the different age groups 25-35, 35-45, etc., for England and Wales as a whole in 1901. The total number between twenty and twenty-five he has represented by the number 100, and then seen to what figure the remaining age groups would come when worked out on that proportion. He has then compared with this the age distribution of males in certain specified occupations, namely, "Metals, Machines, Implements, and Conveyances," and "Dock Labourers." The results are given in the following table : We quote Mr. Beveridge's comments upon these figures. "For every 100 dock labourers at each age between 20-24 there are 118 at each year from 25-34, or forty per cent. more than the 84 to be expected if their age distribution followed that of the whole. male occupied population. To this extent, therefore, the group of riverside labour is recruited by the transference of men from other groups between the ages of 25-34." A little reflection upon these figures will show how unjustifiable such an inference is. For everything depends upon how far the base group represented by the figure 100 has increased or diminished. An example will make this point clear. Let us imagine an industry which in 1891 contained 100 people between the ages of 15-25. Ten years later, in 1901, if all these people remained in the same industry there. would be 100 people between the ages of 25-35 in this same industry, unless some happened to come in from outside, or some died. Now, let us imagine that only fifty of the younger generation came into this industry between the ages of 15-25, between the years 1891-1901. Then in the Census report for the year 1901 we should find that there were 50 people between the ages of 15-25 and 100 people between the ages of 25-35. If we then take 100 as representing the people between the ages of 15-25, we shall have to represent the people between the ages of 25 35 by the number 200. Then, according to the inference which Mr. Beveridge has drawn, we should say that for every 100 workmen in this group between 15-25 there are 200 between 25-35. To this extent, therefore, the group is recruited by the transference of men from other groups between the ages of 25 35. But, as we have seen, such an inference would be absolutely |