Law of 1911 contained several paragraphs expressly designed to facilitate such procedure. The utilization of the right, altho still small (1912: 2.81% of all cases) has steadily increased. The figures for 1912 show an increase over those for 1906 of 73.4% in the number of cases so handled, and of 87.6% in the amount so expended. It is naturally difficult to induce the Berufsgenossenschaften to assume expenses not required of them, and a large increase is not immediately to be expected - nor is it in all cases desirable.❜

Many writers have remarked on the superabundance of appeals from the lower courts, in pension cases. The overburdening of the Imperial Office was to some degree relieved by the law of 1911. Many appeals are for cases of obvious simulation. Under the present system, appeal costs the litigant nothing. Bernhard urges a change. Already the Imperial Insurance Office may in some cases charge costs to the appellant, but has seldom done so. General opinion recommends further exercise of the right. Bernhard's pro

posal is once more justified, but not at all new or radical." Almost one-half of the pensions granted are for under 25% of the normal wage. Pensions of 5 and 10%, which are often granted, are really nothing more than a gift. In 1911, the government proposed that pensions under 20% should be

1 Book III, II, 2, §§ 573–576.

* In 1906, 1.96 % of reported accidents (1.52% of rural cases; 2.65% of industrial) were taken over by the accident insurance authorities; in 1909, 2.40%; in 1912, 2.81% (3.48% of rural, 2.65% of industrial). From 1896 to 1906 the amount of such care had barely maintained the same level. The cost in 1896 was 478,552M.; in 1906, 714,072M. See Kaufmann, Schadenverhütende Wirkung in der deutschen Arbeiterversicherung, pp. 57-76, and Amtliche Nachrichten des Reichsversicherungsamts, February, 1914, p. 292.

See Stursberg, p. 24.

• Stursberg (p. 24), for instance, says that his experience leads him to believe that laying even a small portion of the costs to the appellant would exercise a strong deterrent effect.

• His figures as to appeals are, however, misleading, as he includes the unsettled claims of the previous year. Instead of 170,000 there were about 70,000 appeals in about 400,000 cases in 1911, 17.18% of all cases. Both amount and success of appeals have shown steady decreases since 1895. See Wissell, vol. ii, February 1, 1913.

• Wuermeling (p. 54) says, “three-quarters " but he is in error. He takes his figures from the Leitfaden zur Arbeiterversicherung des Deutschen Reichs, Berlin, 1913, p. 47, but the figures he quotes are for incapacity for work from 0% to 25%-thus including

granted for a limited period only.

Political considerations

prevented the passage of this provision.

1

Bernhard justifiably renews the proposal. Stursberg approves it, and Wuermeling brings no sufficient argument against it.

5

2

Bernhard's final and most important proposal is that lumpsum compensation be adopted in cases of "accident neurosis." Such a plan has been tried in Switzerland, Denmark, and Sweden with marked success. In most cases where the patient is obviously suffering from pure traumatic" or "accident neurosis," the prompt settlement of his claim effects a cure. Medical opinion seems cautiously but generally to support Bernhard's proposal. The question is still new and requires further study. None of the investigations are based on very extensive data. The present German law allows lump-sum compensation only with foreigners, or when the pension would be under 20%, and in any case only with the consent of the insured.

There are, of course, certain general objections to the principle of lump-sum compensation. Bernhard mentions only one, that with low caliber persons the compensation is very soon spent and they once more become a burden upon society. More important is that advanced by Wuermeling. While the pension can at any time be raised or lowered as the effects of the accident vary, lump-sum compensation may be, once for all, either too high or too low. The patient may live too long or not long enough. This argument, however true when applied to the insurance principle, is not relevant when that very adaptability to the patient's varying condition is

Naegeli, Nachuntersuchungen bei traumatischen Neurosen (Korrespondenzblatt für Schweizer Ärzte 1910, No. 2,) reports cures in every case of traumatic neurosis uncomplicated by objective disease.

• Wimmer, Die Prognose der traumatischen Hysterie und ihre Beeinflussung durch die Kapitalabfindung. Zentralblatt für Nervenheilkunde und Psychiatrie 1910, pp. 117-123 reports from Denmark 93% cures after such treatment.

Naegeli, Uber den Einfluss von Rechtsansprüchen bei Neurosen, p. 20, reports, after Bihlström, 90% cures in Sweden.

• See Wuermeling, pp. 54-59, Fassbender, pp. 76-78, Stursberg, pp. 25-26, SchultzeStursberg, pp. 28, 50 for very moderate opinions; Laquer, Naegeli, Horn, Über nervöse Erkrankungen nach Eisenbahnunfällen Bonn, 1913, Wimmer Leppman in Zeitschrift für ärztliche Fortbildung 1911, No. 22, etc.

in large part the cause of his continuing incapacity. Lumpsum compensation may be in such cases, as Wuermeling says, a form of surrender, but as he adds, it is a sacrifice that avoids greater sacrifices.

One further objection is advanced in particular by Schutze.1 It can cause lump-sum neurosis instead of pension-neurosis. It may strongly develop the nervous ailment in the period immediately following the accident; and as Horn 2 points out, lump-sum compensation to be effective must be immediate. This only argues what all doctors seem to agree upon, that this form of compensation, while desirable in some cases, should be applied only sparingly, after thoro medical investigation, and where there seems good reason to believe that full capacity for work may be restored. The Danish method of an immediate limited compensation followed three years later by a definitive decision is perhaps best.

In Germany further provision for lump-sum compensation

is not likely, it seems, soon to be made.

Such are Bernhard's proposals for reform.

They are not

new, and they come somewhat as an anti-climax after his

One ray of hope he sees We have passed through

sweeping proclamations of disaster. -in growing bureaucratisation. the age of baroque social legislation, he says, and are ripe for an era of rest. We need not fear the growing power of the Social Democracy. Party wars lead more and more to neutralisation — and that means bureaucratisation — of social institutions. In the sickness funds, everywhere, he sees a growing centralization of administration, and this he welcomes. (A curious contrast it makes to his demand for "freedom " from bureaucracy in his earlier chapters.) He sees displayed "the tragedy of all great reform movements, that the unforeseen results are greater than the foreseen." And finally, "after a proud and victorious era of progress the time has come to make fast what we have won and to break the way toward new goals." 3

1 Schultze-Stursberg, p. 28.

Horn, Über Simulation bei Unfallverletzten und Invaliden; Ärstliche Sachverständige Zeitung, No. 12, June 15, 1913.

P. 116.

The influence of Bernhard's brilliant book has been great. It has called forth a vast mass of literature of varying worth. Some is in direct answer to Bernhard, some is less controversial.

To the first group belong, of course, a great number of social-democratic replies, many of them rather wild.1 An exception is an excellent series of articles by Rudolph Wissell, founded upon wide knowledge and supported by significant statistics. Perhaps also written with some political "Rücksicht" is a book by the leader of the "Kölnische Richtung" in the Centrum, Dr. Franz Hitze. This is by far the most important reply that Bernhard's work has elicited. Dr. Hitze has left to Drs. Wuermeling and Fassbender the task of answering Bernhard's criticisms of social insurance; he has himself replied to the rest. As a member of the Reichstag, he has been personally concerned in the passage of many of the measures for workingmen's protection. Some of Bernhard's data he shows to be quite inaccurate, and some of his criticisms petty. I know no better short statement of the theory of social insurance than his chapter on the fundamental conception and aim of workingmen's insurance. This he follows with a statistical summary, and an estimate of the physical, economic and cultural contributions made to the German nation by its social policy.

Wuermeling and Fassbender, in chapters in the volume containing Hitze's criticisms, find fault with Bernhard's interpretation of medical opinion. More thoro is Stursberg's reply, already referred to. Stursberg is immediately concerned with the rehabilitation of his own statistics, which Bernhard had attacked; but he also considers Bernhard's whole discussion of accident insurance. Between Bernhard

1 Perhaps the best of such is Kampffmeyer, Vom Kathedersozialismus zum Kathederkapitalismus. Ludwigshafen, 1913, p. 48.

Rudolph Wissell, Unerwünschte Folgen der deutschen Sozialpolitik. Correspondensblatt der General-Commission der Gewerkschaften Deutschlands, Berlin, 1913, Nos, 4, 5, 6, 7, and 8.

• Hitse, Zur Würdigung der deutschen Arbeiter-Sozialpolitik. Mit Beiträgen von Geh. Oberregierungsrat Dr. Wuermeling und Sanitätsrat Dr. Fassbender. MünchenGladbach, 1913, pp. 122.

1

and his opponents, he takes a middle stand. Neurosis and simulation he thinks far less frequent than Bernhard reckoned, but still significant. From a more thoro preparation of doctors he expects the greatest advance. The columns of many medical journals have copiously discussed the medical problems. The excellent works of Laquer, Naegeli, Wimmer and Schultze-Stursberg, tho published before Bernhard's book, contain important contributions to the discussion of pension versus lump-sum compensation. Naegeli's more recent paper sums up admirably a rather extreme position.

3

5

Not a single economist has come out in defense of Bernhard, if we except the laudatory article of the economic editor of Stahl und Eisen. Zahn, Lenz, and Witzleben have been outspoken in their criticism, as have others too numerous to mention. Alfred Weber, in an essay in which he calls for greater emphasis upon the spiritual instead of upon the merely material conditions of existence, pauses to attack Bernhard severely. Ritzmann, while agreeing with Bernhard's complaint of complexity in the industrial laws, feels them quite necessary.

Social insurance at its inception sought chiefly to soften the contrasts of industrial warfare and to keep the laborers above the poor law line. A third purpose to raise the national health by immediately prophylactic measures has developed in importance since. Bernhard's book has

1 In particular, the Ärztliche Sachverständige Zeitung. One of its editors, Erwin Franck, criticises Bernhard unsparingly, 1913, Nos. 6 and 17.

2 See notes 3 and 6 to page 573.

• Naegeli, Über den Einfluss von Rechstansprüchen bei Neurosen.

• Dr. Beumer in "Der Tag," 1912, No. 282.

Friedrich Zahn, review of Bernhard's book in Zeitschrift für die gesamte Vericherungswissenschaft, 1913, pp. 262–264.

• Friedrich Lenz, review of Bernhard's book in Preussische Jahrbücher Band 151, 1913, pp. 543-556.

7 G. V. Witzleben, review of Bernhard's book in Schmoller's Jahrbuch für Gesetzgebung 1913, p. 489-496.

• Alfred Weber, Neuorientierung in der Sozialpolitik ? Archiv für Sozialwissenschaft und Sozialpolitik, Band 36, 1913, pp. 1-13.

• Ritzmann, Soziale Gesetze und moderne Betriebsleitung in ihren Beziehungen su den Erfolgen der nationalen Wirtschaft. Sozial Technik, 1913, Heft 15.