ACC – perverse incentives and sociopathic policy

Written By: - Date published: 8:55 am, June 22nd, 2012 - 90 comments
Categories: ACC - Tags:

One of the things that has struck me about the Bronwyn Pullar debacle has been the difficulty she has had with the ACC despite having five-star political connections and supporters with education, savvy, and money.

Imagine how the other 99% of claimants get on. Frankly if you’re an average Kiwi and the ACC decides to target you, I suggest it’s likely you’re up sh*t creek.

Which is why it’s extremely disturbing to discover that ACC managers are getting bonuses for getting ACC claimants off the books and getting penalised if they don’t.

Think about that. This government has set extremely strong incentives for managers to remove the means of living from vulnerable and injured Kiwis. The minister claims that means people are going back into work but the policy isn’t get bonuses to get people back into work – it’s get bonuses to get people off the books. Whether they can support themselves or not.

Over the last few years the culture of ACC has become one of interrogation and suspicion – one in which claimants are presumed guilty and frequently denied support they are entitled to. While the government prefers to talk about these people as statistics the reality behind this kind of policy is misery and hardship.

But that’s this government all over. They’ve never shied from beating up on the little guy, whether it’s denying injured Kiwi’s their entitlements, releasing the financial details of solo mums, or threatening the jobs of those who speak out against them. By contrast the rich and powerful get massive subsidies, get laws changed for them, and get awarded our highest honours.

Over at Kiwiblog Farrar is getting his knickers in a twist upset about Andrew Little using the term “sociopath” in relation to Judith Collins. Given the policy she’s presiding over, I can’t think of a more appropriate word.

90 comments on “ACC – perverse incentives and sociopathic policy”

  1. Steve Withers 1

    The coverage I have seen on this so far has NOT mentioned two things:

    1. This is the model US health insurance companies operate on. “HMO” staff get bonuses for rejecting claims and reducing payouts.

    2. This change happened after National took power in 2008.

    To me, these were the two most obvious features of the situations as described. Yet no one seems prepared to say it out loud.

    The front page story in the Herald today obliquely mentions the policy change began 3 years ago….but is careful not to join any dots. Admittedly, I gave up reading the article in disgust about half way through.

    What’s going on here? Are NZ media simply ignorant? Or are they avoiding pointing out the obvious for some reason I’m not aware of?

    As for Collins….she just doesn’t seem like a nice, caring person. She seems like the Boss from Hell you’d avoid at all cost….a stance not really compatible with being an elected servant of the public. She’s a representative….not the Queen.

    • Carol 1.1

      Well I think the MSM are fudging these things a little. They also focus on the Pullar case, with her problems starting under Labour’s watch.

      I have seen media coverage mentioning ACC now using an insurance company approach, but I can’t remember when. Certainly it’s something that’s not mentioned a lot.

      Also, it’s not just claimants being pushed off the books in relation to work. Part of the problem is people being denied surgery they are entitled to.

      Some lawyers and independent orthopaedic surgeons criticised ACC over its crackdown on surgery access.

      They alleged it relied on brief, weak opinions from its doctors, some of whom had retired from treating patients and were often not specialists in the areas they advised on.

    • Carol 1.2

      On reflection, the NZ Herald article today is putting the blame onto ACC – possibly in support of preparations to privatise it? So it wouldn’t help that cause to mention it is already behaving like a private insurance company. This is where the article puts the originating blame:

      ACC’s strategy around long-term claimants dates back three years when the corporation identified them as a threat to its long-term financial sustainability.

      A 2009 Executive Leadership Team Issues Paper by senior manager Phil Riley outlined a tougher new approach to long-term claims, including a “culture change” he said should foster “a stronger balance by staff between customer focus and scheme-liability management, and increasing personal responsibility by clients”.

      Mr Riley estimated that the strategy could reduce ACC’s liabilities by $900 million to $1.4 billion by next year.

      However, whether by accident or design, the article does vaguely point to this shift being towards ACC operating like a private insurance company:

      Mr Stewart said long-term claimants have dropped by about 1200 since November, to about 10,400-10,500, but denied he was put in the job to move on claimants.

      He said only 20 percent of staff incentives relate to rehabilitation.

      “I’ve worked in insurance for 28 years. I believe the process of insurance, providing for people when they have accidents, is a noble purpose in fact, and I think ACC is paramount in that in New Zealand.

      Mr Stewart acknowledged recent scandals had affected the ACC’s image.

      The bold in the quote was added by me, and indicates 2 dots that can be joined up to indicate the shift, under NAct’s watch, to move ACC to be like a private insurance provider.

    • just saying 1.3

      I’m repeating what I wrote on open mike today in full now this has opened up into a post of its own. What galls me most is that the private insurance model disentitles claimants according to the ease of getting rid of them. And those with the least resources, who are in the greatest need of support are “low hanging fruit” in actuarial terms. Yet these people have compulsarily paid their levies like everyone else. I think Pullar was not exaggerating when she said of long-term, severely injured claimants: “ACC is no longer accessible to ordinary New Zealanders”.

      Research by Hazel Armstrong et al* has shown that the majority of long-term ACC recipients are not “rehabilitated” when they are exited from the scheme, and it is wilful deception to describe disentitlement of the disabled in this way. In fact most end up on WINZ, or working part-time in low paid jobs.

      Long-term claimants are the most seriously injured, and most are permanently disabled. Protecting catastrophically injured workers from having themselves and their dependant families effectively beggared by their accidents, as happened in the past, was one of the most important reasons ACC was set up.

      But using an actuarial business model they are expensive liabilities, and around an average of $500,000 in lifetime costs is immediately erased from the debit side of the ledger when such a claimant is “rehabilitated” onto a WINZ benefit. Experience from insurance companies around the world, including those prosecuted for such practices, shows that highly vulnerable injured people are often in no position to fight the rich and powerful company legal teams and those that hang on for grim life through the initial efforts to disentitle them can be worn down financially and psychologically, by repeated assessments by “hit-man’ in-house medical assessors, and harrassment via well-worn insurance industry “gaslighting” techniques**.

      *I’ll look it out and link it if anyone is actually interested in reading the material.
      **For details of many of these kinds of methods used by ACC, see Pullar’s 50-odd point list of grievances.

      edit: and yes Olwyn (below) it terrifies me that many of these techniques and some of the same specialist assessors and being prepared to harass WINZ beneficiaries very soon

      • Carol 1.3.1

        This one by Armstrong et al, was published in 2007, and was looking at some outcomes under the Labour-led government watch. It focuses on some ACC claimants who had returned to work. It did not look at people whose claims had been refused or overall stats.

        http://www.hazelarmstronglaw.co.nz/reports/Vocational_Independence.pdf

        It points to such things as lack of independence of clinical assessors, and people getting lower paid work or more part time work than before their accident.

        This 2011 article, associated with Armstrong, but not authored by her, focuses on the use of age-related “degenerative” conditions – something that came under scrutiny after the shift, under the NAct government watch, to reject claims due to pre-existing/degenerative causes. It regulars that that “degeneration” is a confusing, imprecise and misleading term and shouldn’t be used.

        http://hazelarmstronglaw.co.nz/beta/wp-content/uploads/2012/02/Wigley-et-al-Degeneration-the-use-and-mis-use-of-an-ambiguous-word.pdf

        • just saying 1.3.1.1

          Thanks Carol,
          I was aware that the research took place during the Labour Government. Like in so many areas, the National government has merely turbo-charged corrupt and unfair practises that thrived under Labour.

          To quote the study of 160 long-term claimants disentitled after being deemed “vocationally independent” by ACC assessors:

          In spite of the high threshold required to legally overturn an ACC vocational
          independence decision at review or appeal, only a small minority of the sampleset
          achieved vocational independence in reality. That is, they were able to return
          to and sustain work of 35 hours or more in the jobs identified by the ACC
          assessors

        • tracey 1.3.1.2

          in the dbh the so called independant assessors are increasingly selected by how low they are prepared to go on their hourly rate. I wonder if this happens with acc too. And the very low paid may be philanthropic or not up to the job elsewhere so not wanting to bite the hand that feeds…

    • ghostwhowalksnz 1.4

      The industry term for rejecting otherwise valid claims is called ‘underwriting’.

      A variant is accept a claim where they cant get out of it, eg life insurance when the policyholder has …well died but reduce the payout for ‘underwriting’ reasons

    • Anne 1.5

      What’s going on here? Are NZ media simply ignorant? Or are they avoiding pointing out the obvious for some reason I’m not aware of?

      I think there’s an element of fear within some sections of the NZ media although they would never concede it. A concern that if they don’t tow the party line then the govt. will make life difficult for them and they will lose their special privileges.

      Those of us 50-years and over will remember the bully boy tactics towards the media used by Rob Muldoon sometimes to devastating effect. More then one ‘cheeky’ journalist had their career curtailed – albeit temporarily in most cases. I see the same sort of thing happening under this regime although Key, Joyce and co. have learned to be more subtle about it than their predecessor.

      A good example is Radio NZ. During most of his first term as PM, Key refused to to be interviewed on Morning Report. Even now, a Key interview on Radio NZ appears to be quite a rarity.

    • xtasy 1.6

      Having lived in other parts of the world, I can confidently say, that the NZ media (print, but especially television and radio) is one of the worst I have come across.

      Also bear in mind, that “the media” in NZ is mainly purely of a corporate, commercial type, as APN and Fairfax dominate the print media, as such like Mediaworks, the Radio Network dominate radio, and as the same in some ways applies to television.

      Alternative media like Stratos get driven out of the market, more informative public television like TVNZ7 get the axe by a government not interested in an informed public, and TVNZ’s remaining channels being run in a very similar way as their commercial competitors. If it were not for Maori TV (slowly also advertising more), after July this year, there won’t be any true, quality public television available in NZ.

      Sky takes the rest, and of course we know, who owns and runs that.

      This leaves the internet, but who as a user and consumer wants to spend hours going through the wide variety of blog sites and alternative media sites?

      The public is getting more brainwashed and thus “dumbed down”, leaving only a smaller segment of society still reasonably informed and able to make balanced decisions.

      Mainstream media does kowtow to the government of the day in many ways, partly as it depends of it (public broadcasting), partly due to not wanting to rock the boat and suffer the consequences of being shut out, which means a “disadvantage” to those licking the government member’s boots.

      Sad state of affairs, but ideal for a kind of dictatorship.

    • Vicky32 1.7

      What’s going on here? Are NZ media simply ignorant? Or are they avoiding pointing out the obvious for some reason I’m not aware of?

      That is the question!

      • bbfloyd 1.7.1

        And a very good question it is vicky……

        one answer is that the senior “journalists” within the fourth estate power structure owe their positions to to those dictating editorial policy( the owners of our current govt)…

        Another aspect that i have read about(can’t remember which link, but it was on this site), is that all the current crop of “senior television journalists”, and a fair percentage of print journalists, were shoulder tapped at university, because they had been identified as having the right politics, and having compliant natures……..

        No doubt, there are other, equally valid reasons for this state of affairs, but these will do to start…

  2. Olwyn 2

    Just going by anecdotal stories I have heard over the past year or so, I suspect that something similar may be happening at WINZ; that the concepts of getting people into jobs so they will not need the benefit and simply getting them off the benefit, or denying them one in the first place, have been conflated, so as to count as achievements in both cases. The idea seems to be to make it so hard to get on a benefit that you will look around for a relative or friend with a spare couch rather than persevere.

    • IrishBill 2.1

      I think WINZ have had similar policies in place since the early 90s.

      • weka 2.1.1

        Yes, but no-one could get any evidence. RNZ said they couldn’t find out enough about what was going on to report on it. The thing that interests me about the ACC case this week is that the information has been leaked. Does this mean that both ACC and WINZ keep very tight control over anything in written form that confirms the policy? It would be interesting now to see an OIA request to WINZ, or questions in parliament.

        • John M 2.1.1.1

          A group some time in the 1990s used the OIA to expose performance targets around the level of deductions from weekly benefit payments to repay debt beneficiaries owed Work and Income for receiving help they had to pay back. The problem wasn’t about beneficiaries having to repay certain kinds of help they received rather than with the amount of the repayments. There was an across the board increase in repayment levels sometimes up to $80 or $100 a week. Same principle as ACC performance targets. What’s worse with Work and Income is that their fraud people have similar targets which means people are getting done for fraud when there’s no fraud at all. This has been happening for years and years. There are loads and loads of people who are being forced wrongly to repay debt or have even been imprisoned when there’s no fraud at all. It’s absolutely shocking but nothing happens because, as I’ve said, this government has created such a negative climate of opinion around receipt of a benefit that nobody gives a stuff.

      • xtasy 2.1.2

        IrishBill: Yes, but what WINZ do is even worse!

        It was under the last Labour led government that MSD in 2007 introduced the positions of Principal Health Advisor and Principal Disability Advisor, who have since overseen, “mentored”, instructed and liaised with internal Regional Health and Disability Advisors, and also Health and Disability Coordinators. The latter ones do under the PHA and PDA also intensively work with the medical profession and especially so-called “designated doctors”, who WINZ uses for getting supposedly “independent” second opinions or reviews from for applicants or recipients of sickness and invalid’s benefits.

        What should be of immense worry is that since 2008 WINZ and MSD have been “training” these designated doctors (who are almost exclusively GPs), in regards to how MSD and WINZ work, what they “expect” and how they best work with them when making decisions on clients.

        The person who is the Principal Health Advisor, who actually himself has been involved in, and otherwise managed and overseen this “training” is a Dr David Bratt (GP) from Wellington.

        He has a very staunch conviction that “work” is the best kind of “medicine” for people to get well and back to work.

        Just viewing some “presentations” he has launched, see the following links, and the picture becomes clear, as what MSD and WINZ are now doing and have been doing since at least 2008:

        http://www.rgpn.org.nz/Resources/Conference-workshops-2011.aspx
        (download the PowerPoint presentation by Dr David Bratt, given on 18 March 2011 at the NZ Rural GP Network conference, detailing “issues” re “clients” or “patients” pressuring doctors);

        http://ips.ac.nz/WelfareWorkingGroup/Downloads/David-Bratt-Benefit-Sunshine.pdf
        (a pdf presentation he also likes to use in meetings, conferences and the likes, where he presents his and thus WINZ’s position re “benefits” and how it may affect your “health”);


        (the first of four parts of a presentation he held at the Welfare Working Group Forum in 2010, see the other parts also – all available via YouTube!).

        ACC Forum posters and members have been aware of these things for years:
        http://accforum.org/forums/index.php?/topic/7309-drs-anthony-djurkovdavid-bratt-peter-jensen/

    • John M 2.2

      Yes, in fact it’s in a number of ways far worse in that Work and Income often deny people the opportunity to make applications in the first place which means the extent of the problem isn’t reflected in the statistics. There are also incentives for case officers around establishment of debt, prosecutions for “fraud” etc. And of course it’s easier for this government department to get away with far more of this sort of behaviour because it deals with the most vulnerable. On top of this the climate of hatred towards the poor that this government has generated allows Work and Income to get away with it because basically nobody gives a stuff about this group of citizens any more.

  3. Pete 3

    ACC is getting far too political. Responsibility for appointing the chief executive of ACC should be moved to the State Services Commission, like a public service department, rather than a sinecure granted by the minister.

  4. glg 4

    Only 20% of staff iniatives relate to rehabilitation. SO – you can increase or decrease your income by 20% – 20% more if you do what the message baords are complaining about – sending people to specialist after specialist till they get an answer they like, changing file notes after the fact, telling big fat lies. 20% less if you treat people like people.Go figure.

  5. muzza 5

    Its no different from other industry, where individuals at various levels have their pay and bonuses tied directly to budget savings. It make for a generally awful workplace, but that is how the systems have been designed, and they are working as they were intended.

    ACC was built with caring in mind, so to hear that this goes on, is not a surprise in any way.

    Simply it is more divide an conquer, and society coninues to be broken down, the vile extracts keep coming out.

    Starting to read like a smear campaign against ACC, where if you expose it as broken enough, the public will go along with the eventual “opening up”

    we are all under attack, as are the functional systems which are needed to hold society together, make no mistake about it!

  6. ghostwhowalksnz 6

    The point to go after Collins is her claim, ACC is getting them ‘back to work’

    My bet is that only in very few cases are they in a full time job. The rest are on the unemployment benefit as the medical finding of ‘fit to work’ happens before the ‘suitable job is found’

    No longer their problem, they kick the can down the road to Winz.

    • Vicky32 6.1

      No longer their problem, they kick the can down the road to Winz.

      Exactly! I am worried about a friend of mine…

  7. ianmac 7

    Keep in mind the downside of Performance Pay when looking at Government plans to bring it to Police and Teaching. Shifts the motivation of the potential beneficiaries of PP.

  8. prism 8

    Performance Pay should be applied to politicians.
    Kevin Hague sounded good this morning. Made good points convincingly.

    • Steve Withers 9.1

      They need to be wearing blue rosettes and resemble Tony Ryall, Judith Collins and John Key. Add any other ‘let them eat cake’ types you’re aware of.

  9. vto 10

    The incentives and bonuses should surely be for accurate assessments, which can be judged by the number of successful appeals or reviews.

    This method of incentive and bonus is pure evil. And outside the scope and purpose of the ACC law I imagine.

    Evil.

    Nasty.

    What was that other word? Sociopathic.

    That is exactly what it is and good on Andrew Little for outlining it and calling a shit a shit. On many occaions I think the terms used between MPs should be raised a notch. Call a liar a liar and a hypocrite a hypocrite. Ramp it up Andrew.

    • Steve Withers 10.1

      The problem is that these methods are standard practice in the American health insurance industry…..the very same model this government is trying to move us to by stealth. Fascinating they would use the same methods to wreck and smear ACC…only to replace them with private providers who are even less accountable and who have no explicit public mission.

      To me, this just more proof that National is the party for ignorant people (thus rendered functionally stupid) ….and we appear to have a lot of them in New Zealand judging by how people voted.

      That Bill English INTENDS to lower interest rates (cut incomes to savers and underpin the housing bubble) and lower the exchange rate (raise prices for everyone – affecting the low income earners and the the elderly the most)……shows me they are DREADFULLY stupid in many very important ways.

  10. Kevin 11

    In this instance the rot would have started at the top. What were the performance bonuses paid to the departing Chairman and C.E.O.?
    I’m sure the figures would make people puke.

  11. RedFred 12

    Nick Smith should be banned from holding public office he is responsible as much as Collins for the state of ACC. His nefarious activity bordered on corruption.

  12. lenore 13

    Just want to point out that they were also getting bonuses under Labour – which at the time I was very disappointed about since there had been a lot of money spent on putting case managers through post graduate rehabilitation studies during the late 90s and then basically the govt got rid of heaps of them through horrible micro managing, staff feeling the bonus system was unethical etc. The “get people off and I get a bonus culture” was embedded by hiring of new staff who greedily took hold of this system rather then rehab. So this is not new people!

    Just like both governments hide unemployment by putting people on ridiculous 8 week courses and rotate them like that forever and a day and freak the poor beneficiaries out by sending them automated letters telling them their benefit will be stopped. This has been going on for years!

    I would like more transparency around both these practices and put a stop to it so we can see the real stats!

    • xtasy 13.1

      You are right, it started in the 1990s, and despite Labour led governments did since 1999 slow that process down that road down a bit, overall they listened to “policy advice” from within MSD and carried on with trightening up, also putting increasing pressure on unemployed and naturally the sick and disabled.

      Labour did not act as harshly as National is under Bennett now, but they already engaged in activities within ACC and WINZ that we now hear and read about with horror. Some sadly do not like to hear this, as they have selective perception and opinions.

      • weizguy 13.1.1

        This is simply not true. I worked at ACC during this period and there were no bonuses for getting people off weekly compensation. There was limited scope for a bonus for those staff (across the entire corporation) who were at the top of their pay band and thus couldn’t be given a pay rise. This is a standard approach to remuneration.

        There certainly wasn’t an ability to reduce pay based on bad results.

        • xtasy 13.1.1.1

          weizguy: I am not 100 per cent sure about ACC then, and I am not sure whether ‘lenore’ was refering to WINZ or ACC (back in the 1990s). What I am commenting on is not so much the “bonus” payments, but the general approach taken by especially WINZ, and I am sure also ACC, to tighten up on entitlements, to demand more from clients (and the commissioned medical professionals making assessments) in regards to work and the ability to work.

          I also remember that there were some kinds of bonuses paid to WINZ staff years ago.

          If that has been phased out, then I am happy to be enlightened about this.

        • lenore 13.1.1.2

          All I am saying is that when i returned to voc rehab from around 2003 – 2007, there was definitely a change in culture and I don’t know when you were working but the case managers told me that they got performance pay incentives to basically get people off ACC and reduce costs. And these incentives seemed quite generous to me. And no there was not an ability to reduce pay on “bad results” but certainly they had got rid of staff who I knew who were strong supporters of indepth voc rehab – this was of course done the “public sector” way which is having managers or team leaders micro manage the staff until they quit under the pressure.

          Also – what about the IOA and particularly the nasty VIOA’s – some of my mates who are doctors stated that those doctors who signed up to do the VIOAs basically went on a weekend course to get up to speed. When I questioned a VIOA based on ACC policy, the ACC lawyers threatened the contract of the company I was working for – absolute bullying to maintain a very unfair practice. I never did a VIOA again and have not since as I completely pulled away from ACC work as it was becoming to unethical.

          As I was saying this has been done under the labour govt as well so lets keep both parties accountable

          • weizguy 13.1.1.2.1

            Lenore – I was there around that time and if “the case managers told [you] that they got performance pay incentives to basically get people off ACC and reduce costs.” They were either lying, very confused about how the pay system worked, or you’re conflating the words of others with the words of case managers.

            Creating targets for performance is a difficult job and there were definitely times when the law of unintended consequences kicked in, but the intent was never about kicking people off the scheme.

            • xtasy 13.1.1.2.1.1

              weizguy: “Creating targets for performance is a difficult job and there were definitely times when the law of unintended consequences kicked in, but the intent was never about kicking people off the scheme.”

              Well, as Judith Collins replied to a question in Parliament last week:
              Some may choose to view it like “kicking people off the scheme”, but she was preferring to view it as “helping people back into work”.

              All measures, good or bad, mean or not so mean, are these days nicely packaged into politically correct, corporate style lingo, making it sound as if it is such a great, immensely generous, helpful and nice thing that is being done. A bit like a mediocre or bad product wrapped into fancy, glossy and shiny wrapping on a supermarket shelf. These days managers as well as politicians are experts at this. They can sell dried, flat cow shit as a delicious pizza.

  13. Anyone in a claims-based business knows it’s a perverse incentive to actually give people bonuses based on claims outcomes, whether it’s claims paid or claims declined. Honestly, it’s bad enough even basing performance measures purely on claims paid without considering other work. (because people will try and prioritise claims that are easy to and likely to be paid)

    ACC should be run on a QoS basis, and while productivity has its place, assuming claims should be declined is something you should only do with reasonable cause.

  14. Kevyn 15

    but have they stuffed ACC as badly as theyve stuffed EQC, evicting 7,000 families just to keep foreign reinsurance investors onside?

    http://www.radionz.co.nz/national/programmes/ninetonoon/audio/2521887/the-head-of-eqc-reveals-that-it-has-negotiated-its-reinsurance

    Eight minutes into the interview this exchange occurs:

    “Ryan: Was that a big factor – can I stop you right there – was that government package, where there were winners and there were losers depending on the value of your property ah you were taking a set valuation, was that a really important factor to the re-insurers or not?

    Simpson: Two aspects for the re-insurers why it was important – um – first of all, being really clinical about it, as opposed to you know peoples homes and peoples lives, it takes the worst risks out of the EQC portfolio, out of the New Zealand portfolio, so the houses that are in the red zone were in the land that was most susceptible to future damage in a future earthquake – so that’s really high risk properties – so through the offer that’s been taken out of the portfolio – I feel quite bad talking about it in such a clinical way but in you know the financial markets that’s that’s how its seen um but also you know it it showed that the government understood the value of the contract that we have with the re-insurers – in other jurisdictions around the world the state insurer is often compelled to offer cover above its contract above what its contracted to do and to try and pass those costs oversees so it showed that the government was acting in good faith and that government paid for those red zoned – you know the additional cover

    Ryan: So was their fear that the government would come back and ask for more money from the insurers or or go into legal um negotiations?”

    • For those not in the know, I’m currently working at EQC… so from an insider’s perspective:

      What Ian Simpson was talking about there was whether EQC (and thus the re-insurers) or the Government paid for red zone homes, not whether houses were red-zoned, and the set value used simplifying the whole red-zone system, allowing both the government and the reinsurers some certainty on how much would be paid in advance. On a personal level, Ian Simpson is definitely really invested in getting good outcomes for people whose property was damaged in the Canterbury quakes, while still managing the technical risks they were discussing on Radio New Zealand, so if you came off with a bad impression, I can only say that he was talking about a topic that hard to explain the details of without sounding like you don’t care about people. He definitely does.

      While the topic of managing red zones came up, they weren’t really discussing the fundamental idea of red-zoning at all. You should also skip forward to roughly 12:00 minutes and listen to the fact that people are actually very in a very good position financially because:
      1) We offer land cover at all- most earthquake insurers do not. If we didn’t, there might not BE a red zone offer, and people would end up losing all the value of their land and still having to move, and probably to a place much cheaper than they are now.
      2) That the red zone offer is actually very generous when compared to other similar situations, for which admittedly credit does go to CERA/the government.

      If you have issues with the system of red-zoning itself, you’re not really talking about anything that Ian Simpson controls, (EQC is essentially following government directives there) so I don’t understand why you’re quoting him rather than talking about Gerry Brownlee. While the government did take a fixed valuation of people’s homes in such a way that there would be “losers”, (any system with tolerable response times would have had losers- at least this way we reduced the amount of inspections to be done drastically while still allowing people to get paid) they also did set up the system to in general be quite generous.

      It’s obviously terrible for people who are forced to move, but given that suburbs were built in unsuitable areas in the first place, (which again, is no fault of any actual residents’, and in my opinion is the real thing to be angry about) how else would you have us handle the rebuild other than some sort of system that prevents people from rebuilding in those areas where the land is not suitable? This seems by far the “least worst” option for everyone involved.

      • Kevyn 15.1.1

        Enough of the spin doctoring.

        The facts are that the Feb 22 event caused bedrock deformation which dropped some parts of the city well below the 11.8m level (CCC datum). These areas, which are along the lower reaches of the Avon River and adjacent to the Waimakariri River mouth, were already located within flood management areas. Consequently the new height makes the land uninsurable unless filled to the original level. Hence the situation is the same as that covered by the Barnier Law in France and being adressed by the LRA in New Orleans. In those countries when a government excercises eminent domain to prevent rebuilding in flood prone areas it must pay compensation at the fair market value pertaining immediately prior to the disaster.

        As with every other aspect of this post-disaster disaster, central government failed to prepare its systems despite ample evidence from the Manawatu floods that the EQC, resource management, building and local government legislation hindered rather than helped post-disaster reconstruction. Now all we are seeing is ad-hoc responses and ad hominem attacks on critics of the governments inadequate and incompetent responses.

        The insurance industry’s response to the string of quakes in Canterbury has been no different from it’s response to the string of quakes in California in the 25 years before Northridge, hence the billion dollar bailout to private insurers.

  15. tracey 16

    My partner had an accident over 25 years ago which led to partial replacement of front teeth. Those replacements had a life expectancy of 15 years and were covered by acc. Two years ago they failed and needed replacing. Acc turbed down coverage with a broad statement about not meeting the criteria. It is then encumbant on us to seek further particulars and/or appeal. All of which takes time. It seems they reject by default and then wait to see who has tge energy to argue. No one belives acc should waste mobey but if it is going to go down the profit model path declined people should have the right to sue any liable party, if any, under negligence.

  16. tracey 17

    It looks like the herald editor allowed a couple of weeks to pass from the pm toy throwing rant about the media before falling back in line…

  17. mike e 18

    I hear Peter Jackson is doing a remake of the exorcist.
    Crusher will play the lead roll.
    Lets hope he doesn’t use special effects to twist her neck off.

  18. Georgy 19

    The nationalgovt would have given a directive to reduce ‘client’ numbers as soon as they won office in 2008. This would be part of the plan to make ACC saleable.

  19. joe90 20

    A nasty piece of work on Mora’s panel this afternoon. Claudette Hauiti, go fuck yourself. Her wee rant begins at 06.50

    begins at 06.50

  20. McFlock 21

    FB friend made the point that the nats are claiming that the performance pay is not an incentive for ACC managers, while also claiming that performance pay is an incentive for teachers. 
       
    tossers.

  21. Case managers agreeing to unethical payment measures are one thing, but i any registered clinicians, doctors, psychologists etc have agreed to such measures then complaints should be made to their professional bodies and they should be held to account. At the very least it constitutes unethical practice. Remember: First do no harm??

    • xtasy 22.1

      Kyle: “First do no harm??”

      I am yet to find a single general practitioner (who are generally the doctors conducting assessments, reviews and so forth), who will openly and publicly take a stand and say anything critical about a colleague!

      Professional bodies of medical practitioners, psychologists and counsellors officially state they do take complaints seriously, and I am sure in some severe cases they will follow them up with sincere intentions.

      The same may apply to the Health and Disability Commissioner.

      But my experience and that of others has been, that they rather tend to prefer “keeping a lid on things” and not take disciplinary actions.

      ACC and WINZ seem to know this and thus their case managers and internal assessors or advisors get away with a lot. Let alone for the fact that most will not even bother taking issues that far. Lack of knowledge, capability and strength determine this, as also Bronwyn Pullar indicated re her case with ACC.

      • Yes, I agree it’s a shame health professions can struggle to take a strong stance on this. I’ve been pretty outspoken on behalf of psychotherapists, but primarily the medical profession needs to stand up here. Many of the ACC employed doctors behavior and decisions based on paper reports only, and no interview with patients are appalling.

  22. burt 23

    IrishBill

    I think one of the not so well elaborated points here is the stupidity of having a state mandated monopoly with such wide ranging powers effecting our lives so dramatically that is entirely at the whim of the government de-jour.

    • felix 23.1

      Yeah, should be at the whim of global capital.

      • burt 23.1.1

        felix

        If there was only two options; status quo or global capital then sure, lets give it to global capital – at least it’s desired outcome is constant and can be measured and managed.

        • mike e 23.1.1.1

          Ask the people off CHCH what they think of private insurance companies

          • burt 23.1.1.1.1

            No argument about that. There we indeed did see the results of insufficient spread of risk in real terms. How well do you think insurance would be doing in all NZ right now if it were state provided no risk by a single monopoly using tax payer funds?

        • Draco T Bastard 23.1.1.2

          Checked out the US health system lately? You know, the one that costs 3 times as much as ours and doesn’t reach everybody? Everything you see coming from ACC now is minor compared to the BS that private insurance does to get out of paying up.

        • felix 23.1.1.3

          No thanks burt, I favour institutions under democratic scrutiny and control.

          Hint: How did the issues regarding the disgraceful internal policies at ACC come to light, and how would that have worked in the private sector?

          • burt 23.1.1.3.1

            Well felix, premiums went up and cover came down…. remind me again how it’s so different than having 1 single private sector choice.

            • felix 23.1.1.3.1.1

              Already answered. Democratic control.

              • burt

                Ha ha, yeah… democratic control… You are a half thinker felix.

                the stupidity of having a state mandated monopoly with such wide ranging powers effecting our lives so dramatically that is entirely at the whim of the government de-jour.

                I’m so glad you notice that ACC is at the whim of the voters… the tyranny of the majority… I guess if somebody else had suggested that perhaps a bi-partisan approach to accident insurance you would have agreed but because I pointed it out I must be wrong. You are a muppet felix, get over yourself and read what is written not formulate an attack based on who wrote it.

                • felix

                  No, it is self evidently under democratic scrutiny and control.

                  If it weren’t, we wouldn’t be discussing these problems at all, as Kevin Hague MP wouldn’t have been able, using the OIA and other democratic controls, to find out about them and hold a Minister of the Crown to account in the House of Representatives you mong.

                • Draco T Bastard

                  There’s no such thing as the tyranny of the majority – that’s just a scare phrase invented by the thieves to make us doubt our own wisdom and thus keep themselves in power.

    • Steve Withers 23.2

      ACC was the best model if the government de jour doesn’t change it.

      This government has changed it more…..just as their previous incarnation in the 1990s began the process of wrecking ACC.

      Tossing the toys out of the cot and moving to a private model that we KNOW doesn’t work isn’t a solution at all.

      Better to work on getting a government that can restore this scheme to what it was intended to be…..than to use the failure of successive National Party governments as a reason to throw away a great model that actually works…and in the process give the National Party’s insurance company backers exactly what they want in the process. In other words, we shouldn’t reward them for sabotaging it.

  23. mike e 24

    bullshit burt Research has shown we have the cheapest accident compensation insurance in the world!
    try living in Aus state by state they have different systems the private insurers are just a joke .
    One friend of mine was making $1,400 a day installing lifts in Queensland other workers were supposed to have installed brakes in the lift they were never installed consequently the lift fell down the shaft permanently injuring my friend it took him 12 years of constant pain and battling to get compensated a lesser man would have given up,
    Another friend of mine was walking along window shopping the high St of Brisbane on holiday from contracting job in china.He got hit by a 20 tonne truck that shouldn’t’ have been any where near this road he has not been able to work again.It took him 14 years to get compo.
    Private enterprise yeah right.

    • joe90 24.1

      Aye, some years ago, 2003 I think, my sisters bloke fell down a lift shaft while working as a form work chippie on a Sydney high rise. He’s not worked since and is still waiting on the courts.

    • burt 24.2

      mike e

      bullshit burt Research has shown we have the cheapest accident compensation insurance in the world!

      Measured how? dollars per person spent, fair and equitable outcomes, long term rehabilitation rate, – what exactly. Can you link to this claim?

      try living in Aus state by state they have different systems the private insurers are just a joke .

      Yes, but you could claim the premiums off your tax, you knew what you were paying for and what entitlements you have. – how’s that working out with ACC?

      One friend of mine was making $1,400 a day installing lifts …. other workers were supposed to have installed brakes in the lift

      At least 12 years ago? I’m thinking RBA Inflation adjust that to today. Thats 2,032/day today. (I used 1999-2011 because it wouldn’t let me have 2012 – http://www.rba.gov.au/calculator/ )

      So the question is – if you earn circa $2k/day AUD how much do you spend on insurance – or not?

      • Draco T Bastard 24.2.1

        Measured how?

        Why don’t you go read it burt and become informed.

        how’s that working out with ACC?

        Much better thanx.

      • mike e 24.2.2

        treasury figures burt the braniless

        • burt 24.2.2.1

          mike e

          So “your mates” spend (or not) on workplace accident cover is available via treasury then ?

          What part of … So the question is – if you earn circa $2k/day AUD how much do you spend on insurance – or not? makes you suggest I go look at the treasury website ?

  24. joe90 25

    WorkSafe

    Victorian businesses pay Australia’s lowest average workplace insurance premiums – 1.338% of remuneration, but industries with a lot of injuries will pay well above the average,” he said

  25. Murray Olsen 26

    I think most of the Nactional front bench are adequately described as sociopaths.Very few people seem to go into electoral politics for good reasons, and even less on the right.
    I had experience with ACC in the mid 90s. After about 14 years being told I would have to live with a bad back from an accident, my sister married a doctor. A friend of his was a spinal surgeon and we managed to convince ACC that I needed an operation. I had to pay about half. The help they gave with recuperation was basically to send someone a lot like Crusher Collins around to tell me I was soft and just needed to harden up a bit. The level of surgery they were prepared to help with was so adequate that tonight I can’t get up from my bed to go to the toilet.
    Remembering that those were the good old days, I can only imagine what they’d be like today.

  26. TighyRighty 27

    I really love our media when partisan supporters attack them for “not reporting”as the critics see fit to proclaim.

    More so than teachers, media types reporting on politics perform an altogether more thankless role, no one for a minute assumes they do it out of anything but self interest. It makes me happy when I see all sides have a crack at the “msm”. It means it’s doing it’s Job. Maybe not to the fullest extent of its peoples capabilities, but remember the audience is wider than those who are either for a media that supports right (and gets it wrong or right depending on political leanings) or left (and vice versa).

    • xtasy 27.1

      TightyRighty:

      Yes, of course, when coming from your position and your view on matters, they seem to be “doing their job” quite well, by distracting from real matters, not bothering with investigative journalism, not reporting analysed facts and simply rather catering for the adrenalin stimulated flat-minders who love news about drunken youths in Queen Street or Courtenay Place, road deaths, heavy rain, a bit of snow in parts of the country upsetting traffic, which celebrity has had an affair with whom, who has the most bizarre tattoo on the bum or elsewhere, and selling it via Trade Me, on one liner news about the selected few poltical issues, about heaps of rugby, cricket, and where else NZers successfully engage in sports.

      That is about the bulk of where the msm does “do its job”, right? Tight right?

      Dumb down, stimulate the nervous system to discourage in-depth thinking and only perhaps listen up, when some former National Party top shots end up fighting about a “settlement” with ACC for themselves, only claiming some strange kind of “social conscience”, once they have been exposed for having attempted to look after number one before anyone else for so many years.

      Have a good sleepin, as you appear to have been posting this after a long night out.

      • Anne 27.1.1

        who love news about drunken youths in Queen Street or Courtenay Place, road deaths, heavy rain, a bit of snow etc. etc.

        You forgot the minute and gory details at murder trials xtasy.

        • xtasy 27.1.1.1

          Anne: Crime beats all other news bits, it is prime category A stuff for news, and it is usually at the very top of the list of the television news programs.

          Watching the news on TV makes one think, that this country consists largely of extremely bizarre, ruthless, violent, hateful crims, who threaten the so fearful, weak, meek and innocent majority dutifully working hard day in day out, to keep the wonderful system going.

          It polarises, spreads fear, and thus it controls a lot of the public, putting them under mental and emotional “lock down” mode, especially if a suspected or convicted criminal is on the loose.

          So how uninteresting it would be to report about someone with a bad back not getting medical treatment, not being able to work and getting a short shift from ACC or WINZ.

          With crime news they also always make sure to mention whether an accused has been a “beneficiary” of types, as that just adds to the spiceyness of the news. It help also to reinforce the perception, that welfare and crime go hand in hand.

          “Perfect” media for a “controlled” and dumbed down society!

          • Vicky32 27.1.1.1.1

            With crime news they also always make sure to mention whether an accused has been a “beneficiary” of types, as that just adds to the spiceyness of the news. It help also to reinforce the perception, that welfare and crime go hand in hand.

            I heard Carolyn Henwood on Radio NZ this morning talking about children in foster care . They shouldn’t go to (their own) crim families, she says – or they’ll end up ‘on benefits or in mental homes’. WTH,  I thought. “mental homes” is not a term in either law (her area of expertise) or medicine. This so called ‘expert’ was spouting all the crap above, as was ‘Sunday’ last night – beautiful innocent woman killed by mad evil stalker an unknown and unstated number of years ago, now her shocked parents discover that because he’s been in a ‘mental home’, he’s let out for as long as a week on leave! So much for their sterling efforts to keep him in  for 7 years past his parole date (they thought they’d been successful – and purely for reasons of vengeance, as he obviously poses no danger to anyone.)

  27. Treetop 28

    Which benefit is the correct one for a person to be on ACC or Invalids?

    The Invalids Benefit:
    The Invalids Benefit is for people who are permanently and severely restricted in their capacity for work or who are blind.

    Permanent:
    Condition that will last at least 2 years or where the condition is such that the person’s life expectancy is less than 2 years.

    Severe:
    Unable to regularly work 15 hours or more per week in open employment.

    http://www.workandincome.govt.nz/documents/invalids-benefit-application.pdf

    Work Capacity Medical Certificate for Work and Income
    http://www.workandincome.govt.nz/community/health-and-disability-practitioners/work-capacity-medical

    A real e.g. on a Work Capacity Medical Certificate for Work and Income
    Read code: Eu 431
    Description: [X]Post – traumatic stress disorder
    ACC: No
    Primary Diagnosis: Yes

    Are there any other treatments or interventions that could assist the person into work? No

    Would you like Work and Income to contact you about this person’s condition or ability to work? No

    Coverage for PTSD should be an ACC issue and not a Work and Income issue.

    If a person is booted off ACC and then they meet the criteria to go onto an Invalids Benefit they are permanently and severely restricted in their capacity for work.

    How many people have come off ACC in the last three years and been put onto an Invalids Benefit?

    I also think that when a person presents with an injury the same clinician can do an assessment for ACC and another assessment for the Invalids Benefit and that 75% of the time the person would be placed onto the Invalids Benefit.

    When it comes to ACC hand picking medical assessors what would happen if jury selection was conducted this way?

    Hope the links work as I have found Work and Income links to be a bit dodgey.

      • xtasy 28.1.1

        Once a person who should really be on ACC ends up on the invalid’s benefit, the next round of “culling” sets in at some time soon afterwards. Measures already apllied, since Future Focus came into force a year or two ago, see to it that many on the invalid’s benefit are re-assessed by “designated doctors” (“trained” by MSD’s Principal Health Advisor and other staff), who decide, they should rather be on the “sickness benefit”.

        Once the next phase of welfare reforms comes in soon, then sickness beneficiaries will be lumped together with ordinary unemployment benefit recipients, and receive a “jobseeker” benefit or allowance. So yet a further round of “pressurising” and “sorting” will be implemented then, pushing more down the ladder, forcing them to work at least part-time.

        “Work” is highly beneficial and therapeutic for ill persons, as Principal Health Advisor David Bratt is convinced of! See the links provided in py comment above (2.1.2).

  28. Treetop 29

    I always look carefully at your comments because of how aware you are of Work and Income and ACC issues and I do a bit of research myself.

    I am wondering how long it will take until your GP can no longer do the two yearly medical for Invalids Benefit, possibly in July 2013 as then the new legislation will be in place for sickness/invalid benefit. GPs doing medicals for Invalid Benefit every two years was introduced under Labour about five years ago.

    Until my hearing went in my left ear I always did 15 hours advocacy (un paid) per week. I will not have my scoliosis operated on (back injury since Jan 1996 and five disc bulges) unless it nearly puts me in a wheelchair. I also have congenital urinary tract abnormalities. I do not dispute that being positively/productively occupied is good for general wellbeing, however I stress the positively/productively as Work and Income will bully some clients and possibly worsen their medical conditions which will result in increased stress. Good luck to Work and Income if they can find part time employment for me. I am partly un diagnosed and I have not mentioned three other health conditions which afflict me daily.

    • just saying 29.1

      The government pundits and apologists like to repeat the research that shows that being in the workforce can improve wellbeing. It adds a useful veneer of caring to their beneficiary-bashing. They never mention research that shows that shit work decreases wellbing compared to unemployment, yet it is primarily shit work that WINZ and ACC push at those who are unwell or have disabilities. Also never mentioned are those that can’t work in the paid workforce at all, or can’t work at the rate that their fellow employees are expected to maintain. Voluntary work in a manner and at a pace suitable for those whose productivity is restricted doesn’t appear to count at all to such people except as a stepping stone to the infinitely important paid workforce, and the benefit to the public good is meaningless to them compared to private profit.

      It’s infuriating really.

      • Treetop 29.1.1

        When it comes to push to shove by Work and Income they will have to do the dirty on their clients, unwell clients will not take bullshit. An unwell person tires easily and usually has a restricted life when it comes to socialising as energy is required for this. There are good and bad days and a 3 is an average day.

        You can’t flog a dead horse, Work and Income need to learn this.

  29. veryinteresting 30

    Theres a lot of valid posts coming out about ACC’s assessors for denial of legitimate injury claims. Heres something i found recently about winz:

    I don’t advise shifting to a WINZ benefit. Not only will your weekly income drop, to a level that is set deliberately below subsistence (what it takes to meet a minimum standard of living in NZ), but WINZ is gearing up to shaft you the same way ACC does – using many of the same doctors (so at least you won’t have to worry about learning their names). Later this year, our dearly-beloved leopard-skinned Minister will introduce a Bill amending the Social Security Act 1964, to provide WINZ with greater powers to dump the sick and disabled off its books. The plan is almost identical to one rolled out (by Labour and Tory governments)in the UK over recent years and is based on “tick-box” medical assessments conducted by multinational firms ATOS and our old friend UNUM Provident, which have resulted in thousands of people having their income and standards of living slashed. The assessment regime was the subject of a damning report from a House of Commons Select Committee (several order of magnitude in terms of quality above our equivalent), which found that it was grossly inaccurate, unfair and unjust. Another difference between the UK and NZ is that the legal system in the former is slightly less hostile towards poor people than ours is: about 2/3 of all people shafted by the UK disability assessment regime, and who appealed, were successful. In NZ, about 5% of those who appeal to the Social Security Appeal Authority succeed (themselves a very small % of the total shafted by WINZ. There is a Benefit Review Committee appeal, too, but it is a total rubber stamp of whatever outrageous decisions are made by WINZ, even worse than our own dearly-beloved DRSL. Currently, WINZ has a “Health and Disability Panel” engaged in copying and pasting the UK assessment regime for use here. Readers of this forum will be delighted to know that the WINZ Panel is headed by none other than our dearly-beloved independent medical assessor, Dr David Beaumont(he of the ghastly McMansion in Cromwell), famous for his work assessing ACC claimants. Beaumont also boasts of his leading role in the UK assessment regime. Oddly, though, his blurb on the WINZ document I have doesn’t mention the slagging his work got from the UK House of Commons. I guess there wasn’t space for it. Nonetheless, I hope I have assisted by drawing everyone’s attention to it in this post. Don’t hide your light under a bushel, Dr B.
    http://accforum.org/forums/index.php?/topic/12445-how-to-voluntarily-leave-acc-and-go-onto-sickness-bft/page__view__findpost__p__129946

  30. Janny 31

    Racist case manager threatened to cut me off again if I didn’t get her permission to go to family Tangi. Uncle Tom pae arahi denied south African CM demanded full private details of my relationship to deceased, my role in their lives, and theirs in mine because my father then sister died and I missed meetings. Reinstated after being disentitled for spurious excuses as part of that ‘low hanging fruit’ to find myself immediately forced into multiple assessments and repeat evaluations under constant menaces and threats of disentitlment. Had to drop out of my own self funded vocational rehab to attend ACC’s sessions OR ELSE! Even denied mobility access at the assessors tho’ I can’t do steps. 9 mths housebound for lack of power wheelchair. Made to lay in urine soaked bed cold shivering coz ACC refused to raise my bed high enough to get out of it in time and peeing into kiddies beach bucket coz ACC refused bedside commode. Bullying Boer forced me to pain shrink when I can’t walk but the case mongrel refuses wheelchair. Told me to attend shrink or have compo cut off again without backdated arrears when I did “comply”. Hospital appalled as I needed specialist treatment not shrink. Told by doctors Pain in all actively inflamed joints not in my head.

    • Treetop 31.1

      Sorry to hear that you are not being treated with respect/fairness and that you have had family loss and that you are trying to manage all issues with your health.

      Are you able to contact your local MP? If they are in government contact an opposition MP who is the ACC spokes person. Not sure of how much help they will give but they need to know that you are not receiving your entitlements and that you are being sent to unnecessary or the wrong specialist assessments.

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