Management’s Views on Dental Care in an Employee Benefit Program

Abstract

The efforts of groups of employees to protect themselves against the risks of accident and illness certainly antedate the twentieth century. Those efforts were not significantly successful on a wide scale until the 1930’s. The literature on the subject indicates that there were hardly any more group health and accident plans in existence in 1930 than there had been in 1900. During the 1930’s, two develop­ ments provided an initial surge to what has been a continuing increase in the number of group health and accident programs. The first of those developments was the establishment by some employers of group insurance plans for employees. Many of those plans were supported entirely by management; others were financed by contributions from both employers and employees. The plans were administered by management and did not result from the employer-employee bargaining pro­ cess. The second development was the enactment of the National Labor Rela­ tions Act in mid-1935. That legislation gave labor groups the statutory authority to bargain collectively on questions re­ lated to wages, hours and working con­ ditions and contributed to the accelerated growth in the number and size of labor unions. During the 1940’s other events com­ bined to continue the rapid increase in the number and scope of health and welfare plans. During World War II the federal Congress enacted legislation aimed at freezing wages at specified levels. With the approval of the National War Labor Board, many employers es­ tablished health and welfare plans for their employees as fringe benefits in lieu of wage adjustments in an effort to keep their labor forces intact. The Bureau of Internal Revenue made its contribution by ruling that employers could treat as a business expense the cost of providing group hospital and medical insurance to their employees. In mid-1947, the TaftHartley amendments of the National Labor Relations Act established a mecha­ nism under which group health and wel­ fare programs could be negotiated and indicated the responsibilities of manage­ ment and labor in the operation of such programs. In 1948 the N.L.R.B. ruled that a union-organized employer must bargain collectively with the representa­ tive of a majority of his work force on questions related to group health and accident programs. These events are the more significant historical landmarks in the emergence of health and accident coverage as a nor­ mally anticipated condition of employ­ ment. Concurrently, during the period 1930-1950, Blue Cross and Blue Shield plans were developed and extensively promoted in many states. Thus the stage was set for the intensive managementlabor discussions during the 1950’s of group health and accident programs as a fringe benefit of employment. Now for a quick look at the position today in this continuing evolution of the principle that health care is an item for negotiation between management and labor. One writer recently offered this interesting commentary: