Merrill Lynch: Nats will privatise ACC

93 comments on “Merrill Lynch: Nats will privatise ACC ”

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1. Nedyah Hsan 1

   2 July 2008 at 12:22 pm

   Im not holding my breath. Unfortunately all the Australian Businesses are getting tired of having to “overpay” monkeys when they were getting a great deal on wages back in the 90’s. Cheap labour and all.

   Can’t see this appearing on the front page anytime soon.
2. pohutukawakid 2

   2 July 2008 at 12:30 pm

   Why am I not surprised?
3. Felix 3

   2 July 2008 at 12:34 pm

   Slippery John may well be known as “dirty John” by the time the election rolls around.
4. Lew 4

   2 July 2008 at 12:39 pm

   pohutukawakid: Because National have never made any honest pretence of wanting to privatise (or open up to private competition) ACC?

   L
5. burt 5

   2 July 2008 at 12:42 pm

   So will the private insurers be able to add levies to my petrol, my income tax, my car AND my mototcycle registration or will I get to see exactly what my insurance is costing me?

   Can I more easily put a private insurers ass in a sling when they send my patient details to the wrong person than I could put a govt agencies ass in a sling?

   Can clients of an insurer vote with thier feet if that insurer is difficult to deal with or treats with the arrogance only a monopoly can get away with?

   Come on guys, get ya shit together. There is no problem with a public funded default provider that covers low income earners and un-waged people – but fund that provider with tax payers money via an annual appropriation so that we can all see what it really costs us.
6. andy 6

   2 July 2008 at 12:51 pm

   Questions:

   How would sports injuries and other non covered events be covered?

   ACC has its faults for sure, what are the benefits to the consumer?

   capthca:factor that
7. forgetaboutthelastone 7

   2 July 2008 at 12:55 pm

   Burt –

   The issue here is that the National Party is telling people they’ll do one thing when actually they plan to do the opposite. What do you think about that?
8. jbc 8

   2 July 2008 at 12:57 pm

   I’m not so sure that allowing private companies into workplace insurance is such a bad thing – provided that the minimum cover required is written in law and is standardised as what is provided now.

   My own experience (with health insurance) has been that private insurers provide a significantly better value for money than NZ govt.
9. Lew 9

   2 July 2008 at 12:57 pm

   burt: You still haven’t given any sort of rebuttal to this line of argument: http://www.thestandard.org.nz/?p=2182#comment-61320

   L
10. jbc 10

    2 July 2008 at 1:09 pm

    That’s a sound argument Lew.

    Question: wouldn’t that be alleviated if the employers were required by law to purchase insurance at a set level of cover? Then the true cost of risky jobs would become part of the business cost – which should eventually lead to those jobs being made safer.
11. bill brown 11

    2 July 2008 at 1:13 pm

    RNZ story here:

    http://www.radionz.co.nz/news/latest/200807021301/2069f698
12. bill brown 12

    2 July 2008 at 1:20 pm

    And the NZ Govt press release:

    http://www.scoop.co.nz/stories/PA0807/S00039.htm
13. Matthew Pilott 13

    2 July 2008 at 1:24 pm

    Private insurance is great especially since it will provide worse cover, cost more, and you’ll be paying for their lawyers and investigators to try and deny you payment when you’re in hospital (it’s bad enough when your car’s been stolen or house robbed, but when you’re sick or damaged – no thanks!), instead of funding a no-fault system. I can see why you’re enamoured with the idea, burt.

    “The report notes that average premiums in New Zealand are lower than in Australia, despite providing higher (universal and no-fault) coverage.”

    Truly awful, cheap premuims AND better coverage.

    Burt – genuine question – can’t you just go online and find the operating expenditure for ACC?

    jbc – wouldn’t the government still have to set the levels of insurance for different industries? If they did this, some would still be more expensive to insure – wouldn’t that make it more expensive to employ, say, builders? Making it a business cost would man that they have to save money elsewhere – wages are always a soft target…
14. higherstandard 14

    2 July 2008 at 1:27 pm

    If the ACC figures are accurate.

    Net income 3.29 Billion, claims liability 13.7 Billion.

    It seems that the only way a private insurer could make money from ACC in NZ would be to provide vastly less cover or only insure those at lower risk.

    ACC is not perfect but before signing up for a private public enterprise (if that is indeed what happens) it will be important to know what it entails. I wonder if ACC would be good question for referendum ?
15. Bethany Mark 15

    2 July 2008 at 1:31 pm

    And ZB report here: http://www.newstalkzb.co.nz/newsdetail1.asp?storyID=140094
16. burt 16

    2 July 2008 at 1:33 pm

    forgetaboutthelastone

    The issue here is that the National Party is telling people they’ll do one thing when actually they plan to do the opposite. What do you think about that?

    Actually I’m desensitised to that aspect of it. Ummm, it’s been a while since I was naive enough to believe that what politicians say is what they mean, I’ll think about that for a while. I need to consider it from the perspective that what I vote for might be what I get rather than just give [xyz-party] a mandate to do what they want once they have the levers of power in their hands. I’ll get back to you once I’ve considered that fairy tale.

    Lew,

    You are correct, I didn’t answer. The answer is however simple, public fund low income/unwaged peoples insurance (via tax rebates, benefits, entitlements, vouchers etc std public funding strategies for individuals) via private insurers or a state owned insurer. Get over the “private business must not profit from public money’ issues and look at the cost of providing the cover/service. “State Insurance’ was set up as a Govt owned watchdog over the foreign owned insurance companies that were charging ridiculous prices for insurance in the early days of NZ settlement. Have they failed because only the “low value’ clients used them? Did they keep the foreign companies in check? Perhaps you could reframe you comment with that “insurance fact’ as a backdrop rather than making up a pile of puff and bluster to support status quo with state owned monopolies.
17. jbc 17

    2 July 2008 at 1:34 pm

    matthew; sure, some industries would be more expensive to insure than others. good. one way of looking at this would be as a cost of employment, I can see that. However the govt has introduced other measures which increase the cost of employment (annual leave, penal rates, etc) and that these might push down wages was not a concern.
18. burt 18

    2 July 2008 at 1:36 pm

    Matthew Pilott

    Burt – genuine question – can’t you just go online and find the operating expenditure for ACC?

    Well yes, but how much is it costing me Matthew? Shall I get my calculator out every time I fill up with petrol and keep a running tab ?
19. Bryan Spondre 19

    2 July 2008 at 1:39 pm

    “New Zealand has lower claims management expenses (8% of total
    expenditure) than all Australian schemes (9% to 32%), and lower
    total administration expenses (24% of total expenditure) than the
    schemes providing comparable benefits (NSW 28%, Victoria 31%).16
    When one considers that, in addition to these administrative
    expenses, most Australian schemes also pay significant legal costs
    for common law claims, it is clear that ACC is paying a relatively high
    portion of total premiums directly to claimant benefits.17” Scheme Review p23

    Sounds like ACC is doing a good job. So when does Labour intend to nationalise the rest of the insurance industry ?
20. Tim 20

    2 July 2008 at 1:39 pm

    The no-fault accident compensation scheme is one of the best things about this country. If it’s privatised it will turn from a public service into an enterprise designed to make profits.
21. Tane 21

    2 July 2008 at 1:41 pm

    Sounds like ACC is doing a good job. So when does Labour intend to nationalise the rest of the insurance industry ?

    Good question. Perhaps you should join the party and put it up as a remit at next year’s conference Bryan.
22. Steve Withers 22

    2 July 2008 at 1:43 pm

    “Get your windfall profits here!”

    “New Zealand for sale!”

    “Come and get it!”

    “Get your windfall profits here!”

    “Aussies preferred!”

    “No risk!”

    “Get your windfall profits here!”

    Yeah….we’ve been here before and it’s realy sad to see National is still the party that will hock off our assets to foreign companies so they can drag our forex balance ever further further into the RED.

    The Australian National Party….John Key, (current) Proprietor
23. Matthew Pilott 23

    2 July 2008 at 1:45 pm

    jbc, those measures (you could include breaks, kiwisaver, parental leave) are of direct benefit to the employee. Increasing insurance costs to allow overseas insurance agencies into the market does not, so I’m not sure the comparison helps.

    burt – if you think the costs are not insignificant it wouldn’t be very hard to keep a tab. You could total your eftops transactions for service stations, and then divide that by the petrol levy percentage if it concerns you enough to make a comment about it here. Or, you could multiply your vehicles’ average fuel comsumption by the odometer distance travveled in a year. It wouldn’t hard if you actually cared, as opposed to wanting to make a scene…

    Alternatively, you could look at international reviews of our system, which aren’t exactly critical, and Lynch’s own report which states that there’s a few billion to be made from us poor saps if National go ahead with their plan – what does that tell you?

    By the way, why should non-drivers pay extra for your dangerous motoring pursuits (if there was meant a single annual appropriation as you suggest. Or do you want to start a massive bureaucracy to calculate what everyone’s individual appropriation should be? Isn’t it just a whole lot easier this way??)? Where’s the personal responsibility in that?
24. Steve Withers 24

    2 July 2008 at 1:47 pm

    Bryan Spondre: You may be joking, but in many jurisdictions health, automobile and workers compensation insurances ARE effectively nationalised. Private operators charge too much and deliver too little.

    …and retirement and unemployment insurance are nationalised almost everywhere.
25. burt 25

    2 July 2008 at 1:49 pm

    Bryan Spondre

    Yes, good call, a levy on wages to pay for home and contents/car/life insurance would be excellent. Go the state monopolies ..
26. travellerev 26

    2 July 2008 at 2:21 pm

    Merrill Lynch has a long history for privatisation research and how to bring it about.
    http://www.burson-marsteller.com/Innovation_and_insights/Case_Studies/Lists/CaseStudies/DispForm.aspx?ID=33&nodeName=Brand%20Marketing&subTitle=Merrill%20Lynch%20Retirement%20Survey

    They have a very interesting PR company. Their name is Burson & Marstellers.

    http://www.corporatewatch.org.uk/?lid=393

    Think of them as Crosby & Textor on steroids.
    Some of their other customers? Cheney, Bush, Exxon, Rio Tinto, Blair
    Blackwater USA, Hillary Clinton to name a few.
    Here is a nice little diddy on them.

    http://www.hartford-hwp.com/archives/27/061.html

    They are also the house PR firm of the Federal reserve. Yes, the same privately owned banking Cartel that invited John Key to his lofty position as “Advisor” to the Feds from 1999 until March 2001.

    If you think that they don’t operate in New Zealand think again:

    http://www.burson-marsteller.com/Global_Network/Lists/OurOffice/dispform.aspx?id=81&nodeName=Asia%20Pacific,2&subTitle=Wellington

    Yep, right there were they can do the most damage, in Wellington.

    Don’t you think it’s strange that John Key who came back to little old Kiwiland to do some good for us local yokels seems to be surrounded by all these international sharks and how they seem to be trying to influence how the Smiling Assassin is perceived? All these sharks by the way that have previously trying to buy up or force us into selling our resources and assets?

    What do you think; Are they all trying to help us the common kiwi folk?
    Naah, I didn’t think so.
27. travellerev 27

    2 July 2008 at 2:23 pm

    Argh, its purgatory again. Help, someone get me out of there?

    [Tane: Done. Our spam filter has been rather overzealous lately.]
28. Lew 28

    2 July 2008 at 2:27 pm

    jbc: “wouldn’t that be alleviated if the employers were required by law to purchase insurance at a set level of cover?”

    Not really. If this level of cover was set at the current level (complete cover for all accidents) this would likely result in the same phenomenon as above: providers cherry-picking the safest employees, offering cover to them, and leaving the ACC system covering only the least-safe industries. At present the system works to a degree because there is not a linear relayionship between premiums and cover. This is the price we pay for security and guaranteed cover for all.

    burt: Good response, apart from the snarky bit at the end.

    “The answer is however simple, public fund low income/unwaged peoples insurance (via tax rebates, benefits, entitlements, vouchers etc std public funding strategies for individuals) via private insurers or a state owned insurer.”

    Fair enough. But the same objection as I raise to jbc above applies to this, too – that people in high-risk categories (which correlates to poverty) will be left in ACC, undermining the whole system. I also have problems with targeted-subsidy methods of ensuring people can access service (such as accommodation supplements), but they’re problems with implementation, not in principle.

    Your State Insurance example is disingenuous, and its disingenuosity (heh) is made clear by your citation of the fact other insurers were `charging ridiculous prices’ for services. In addition, the parallel isn’t valid, because in a country with mostly public healthcare services (funded by ACC among other things), the importance of universal health and accident insurance is much greater than that of property insurance, which is, for better or worse, not universal.

    L
29. burt 29

    2 July 2008 at 2:36 pm

    Steve Withers

    and retirement and unemployment insurance are nationalised almost everywhere, plenty of private providers and lots of choices though.

    I’ve scanned the KiwiSaver web site and I can’t seem to find the state provider, can you please supply a link for me

    You guys are too partisan to be credible sometimes.
30. jbc 30

    2 July 2008 at 2:39 pm

    matthew, the comparison was employers costs vs pressure on wages. relevant no matter what the argued benefit is.
    Permitting competition in providing the workplace insurance is not necessarily going to increase costs. I would expect many would be able to reduce their insurance costs.

    You are aware that ACC already charges employers different rates depending on their industry?

    As an employee all that I would want to know is that the costs of treating my workplace injury are covered. Whether that’s ACC or AMP is immaterial.
31. burt 31

    2 July 2008 at 2:40 pm

    Lew

    Your State Insurance example is disingenuous, and its disingenuosity (heh) is made clear by your citation of the fact other insurers were `charging ridiculous prices’ for services.

    Perhaps we see it differently, I think that is the whole point. If there is a state provided option that provides good value for money people who can afford other options use the state option. Exactly as has always happened with State Insurance. The key to this is: State Insurance was not put in place as a monopoly, the other companies kept it honest and it kept the other companies honest. Without competition where is the motiovator for efficiency?

    PS: Sorry about the snakey bit 🙂

    capthcha: tears state – unreal.
32. andy 32

    2 July 2008 at 2:52 pm

    So the nats plan is to give (tax cuts), and take away(privatise insurance with inevitable rise in costs to consumer).

    Can’t see how this would help this hard working kiwi!

    Oh and is this the same insurance companies who don’t want compulsory 3rd party insurance for all drivers?
33. jbc 33

    2 July 2008 at 2:54 pm

    Lew: if, as you suggest, ACC ended up covering the riskiest industries then surely ACC would find itself increasing the charges to those employers. I don’t see this as a bad thing.

    Just to be clear here: I fully support the idea of completely shared cost (ie: publicly funded) health system. This is where the moral-hazard argument does not apply. Everyone pays and we are all looked after.

    When it comes to workplaces though: employers who run a risky shop should pay the cost or find a safer way to do business (or bugger off). Now if that sounds harsh then I’d remind people that the same argument is made of industries with large carbon outputs: pay the cost or bugger off.

    The biggest difference that competition will make here (and if it leads to the conclusion you suggest) is that the focus will shift more sharply towards the riskiest employers. If the force of law is upheld and employers are responsible for covering workplace injuries then ultimately the safest workplaces should prevail.
34. Lew 34

    2 July 2008 at 2:56 pm

    burt: “Without competition where is the motiovator for efficiency?”

    Yes, I see that, and in general I do support two-tier schemes for this reason. My objection to a two-tier accident insurance system is that it wouldn’t be Pareto efficient. The drain of the low-risk clients out to private providers would mean ACC’s responsibility to bear all the high-risk clients, which would necessarily degrade the quality of service to those clients due to the principle of arbitrage – in all insurance low-risk subsidises high-risk to an extent; the trick is balancing those risk profiles.

    If a system could be constructed that didn’t disadvantage those clients who had no choice, I’d be all for it. But I won’t support a system where those with choices can improve their lot at the cost of those without.

    (Incidentally: Ron Mark (in Parliament) just denied John Key leave to make a personal statement regarding issues raised during Question 1, worded as follows: “JOHN KEY to the Prime Minister: Does she stand by her statement, in relation to the Government’s purchase of rail and ferry assets, that “we are not going into this to make money’?” This will surely be litigated in General Debate after Question Time, so that’ll be worth a listen.)

    L
35. forgetaboutthelastone 35

    2 July 2008 at 3:02 pm

    Burt –

    I’ll help you out some:

    “just give [xyz-party] a mandate to do what they want once they have the levers of power in their hands.” = National Party.

    “what I vote for might be what I get.” = Labour Party.

    It’s not a fairytale, its how a democracy should work.
36. Lew 36

    2 July 2008 at 3:05 pm

    jbc: Yes, this is a good argument, and the parallel to carbon trading is apt.

    I’m not convinced ACC would have the unfettered ability to raise premiums as a stick to reform unsafe workplaces, due to the `compliance costs are putting us out of business’ line. In principle (I don’t know the numbers) this could make some industries non-viable, and that would effectively mean we were trading jobs in mostly high-risk primary industries for jobs in the newly-burgeoning insurance industry. I wonder if that’s a worthwhile trade.

    L
37. Lew 37

    2 July 2008 at 3:10 pm

    forgetaboutthelastone: This isn’t what those Labour voters who oppose the s59 repeal, the China Free Trade Agreement and other controversial legislation are saying right now.

    When you vote for a politician, you are voting for leadership. You must expect that politician to act on the authority you give him or her by electing him or her, and that might not mean the legislative agenda you wanted.

    This is why the policy debate is fundamentally important to the electoral process: it’s the only way you might know what you’re getting.

    L

    Captcha: “easy Middle”. Yep. Pitching for the middle is easy. Acting in it isn’t so.
38. travellerev 38

    2 July 2008 at 3:22 pm

    Thank you Iprent
39. travellerev 39

    2 July 2008 at 3:25 pm

    Hi Tane,

    You can chance the settings of how many links you will allow.
    Go to your dashboard>settings>discussion>change number of allowed links
    Hope this helps
    and Thanks

    [lprent: It isn’t that. That is set to 10 (and you really shouldn’t put more than 10 links in). However akismet is also looking for spam and that is the one that is trapping your comments. We don’t have access to control stuff in that]
40. burt 40

    2 July 2008 at 3:26 pm

    Lew

    I think you are still working hard to justify a state monopoly. All forms of insurance have high risk/low risk clients & high/low value clients. The whole principle of insurance is spreading the risk across various risk/value groups and factors. This is what Actuaries are employed to resolve.

    An insurance company that cannot attract a range of clients with various risk & value profiles to allow it to provide cost effective cover should not be in the insurance business. There are two distinctly separate issues in this that need to be considered, how we fund it and how we provide it. The whole issue of funder/provider split should be on the table for discussion, informed discussion without our partisan “state good private bad’ or “private good state bad’ hats on.

    We would all be very uncomfortable if there was only one commercial monopoly provider, yet you seem to think that if we allow only one state monopoly all of the issues associated with monopolies go away can you explain how you arrive at this position?

    My take on it is, in the private monopoly profits motivate the reduction of inefficiencies and wastage, in the state provider there is little or no motivator for this, but neither monopoly is motivated to provide the best range of choices or to stay cost competitive.
41. jbc 41

    2 July 2008 at 3:33 pm

    Lew: “this could make some industries non-viable, and that would effectively mean we were trading jobs in mostly high-risk primary industries for jobs in the newly-burgeoning insurance industry. I wonder if that’s a worthwhile trade.”

    I hadn’t looked at it that way. I’m certainly no fan of insurance companies and in terms of “people I like to deal with” they probably tie in last place with government departments and used-car salespeople.

    My gut feel (which may be wrong) is that the type of industries concerned (that require manual labour to take risks) are in NZ because they need to be here to fill a local need. If they are not viable in that the business can not fund the risks it asks its employees to take then I would find that business questionable overall. Any business in that position is extremely dodgy.
42. Matthew Pilott 42

    2 July 2008 at 3:40 pm

    burt, i don’t think you need to argue that hard to explain the need for state cover. Have a shot at answering this: would a private company happily lose money to ensure total coverage in a specific area of insurance?

    You mention private insurance reducing inefficiency and wastage – unless they’re willing to adopt a no-fault system, their money will be tied up on lawyers and investigators. In this case the public model is clearly more efficient – it doesn’t need to be competitive, it needs to be comprehensive.

    jbc – I didn’t know that workplaces were charged at different rates. Makes sense though, and while this can provide an incentive to reduce risk, unless private insurers were forced to adopt a government-mandated capped rate for providing cover, and were forced to cover every type of workplace that applied, costs to some workplaces will certainly rocket up. It seems to me that to some degree, those in cushy industries are subsidising those who do the dangerous work (but aren’t adequately compensated)…
43. Lew 43

    2 July 2008 at 3:57 pm

    burt: I am indeed working to justify a state monopoly in this case, but it’s not because I like state-owned monopolies in principle – I only like them when the market fails. In this wise I like the government’s purchase of KiwiRail – because privatisation failed us.

    “An insurance company that cannot attract a range of clients with various risk & value profiles to allow it to provide cost effective cover should not be in the insurance business.”

    The trouble is that ACC doesn’t have the option of not being in the business, nor does it have the option of balancing its client-base. This is the fundamental reason why ACC is different from other cases.

    The fact that insurance must remain compulsory, but that only one provider must be compelled to accept all comers, means that provider (ACC) has a fundamental disadvantage: it cannot spread risk; it must take the risk the client-base provides. Across all industries this is tolerable, since they balance out. Where some providers get to select from the client base knowing that doing so will strengthen their hand in the long term (weakening the hand of a major player in a zero-sum game), there exists a major incentive for those who can choose to skim the `good’ clients, leaving only the `bad’ clients. This leads to the endgame in my argument linked above: the degradation of the system, and its eventual privatisation as a liability.

    Ultimately all monopolies do have problems – the question is whether those problems are worth the collateral benefits they bring. In my view ACC is a rare case when they are.

    L
44. Lew 44

    2 July 2008 at 4:07 pm

    jbc: The riskiest industries when I worked in the business (early ought-oughts) were all primary industry: forestry, fisheries, etc, and these also pay the highest premiums. However the relationship between the value of premiums and the cost of claims is not directly linear, so there is certainly an argument to tie the value of premiums to the cost of claims. I’m not really qualified to comment on what effects this would have, but in general terms, most of these jobs are at the mercy of the international market: you can only get so much for a tonne of wood chips, or of hoki fillets, or of chilled lamb, and anything which increases costs for those industries could have deleterious effects on the NZ economy. Or it could not. That’d require looking at the numbers.

    L
45. burt 45

    2 July 2008 at 4:29 pm

    Matthew Pilott

    One of these days you will switch from ‘attack burt’ mode, I’ll wait till then to engage with you.

    I have said more than once in this thread that a state option is no problem, it’s the monopoly issue that I don’t agree with. Keep reading into what I said what you want to see. More power to you.
46. Idiot/Savant 46

    2 July 2008 at 4:30 pm

    Looks like National has finally come clean and admitted that they will privatise ACC. So, their policy is to screw over ordinary New Zealanders so they can enrich their Aussie mates to the tune of $200 million. Nice to know where they stand…
47. burt 47

    2 July 2008 at 4:35 pm

    Lew

    The trouble is that ACC doesn’t have the option of not being in the business, nor does it have the option of balancing its client-base. This is the fundamental reason why ACC is different from other cases.

    If you can explain how a monopoly can’t have a balanced client-base then we can understand each others position. I would say a monopoly has the most balanced client-base there is, perhaps I’ve misunderstood what you are trying to say?
48. Lew 48

    2 July 2008 at 4:42 pm

    Burt: Oh, yes, poor phrasing on my part. Clarification in italics below:

    “The trouble is that ACC doesn’t have the option of not being in the business, nor does it have the option of balancing its client-base as the default provider in a two-tier system with private providers.

    Basically what I mean is that if ACC is the provider for all the clients the private sector doesn’t want, it can’t possibly balance its client base. It’ll only get the `bad’ ones.

    L
49. burt 49

    2 July 2008 at 5:33 pm

    Lew

    Basically what I mean is that if ACC is the provider for all the clients the private sector doesn’t want, it can’t possibly balance its client base. It’ll only get the `bad’ ones.

    I think we are going to need to agree to disagree on the validity of a monopoly model for ACC. I won’t generally support a monopoly on anything with the natural exception of Govt itself. It’s possibly unfortunate that my position appears to aligns 100% with the National party as far as ACC is concerned. This is a coincidence as I’m not a National party supporter. If National had a different policy (EG: Scrap ACC entirely) then my position might be more acceptable to more people in this thread. Ces le vie.
50. Chlorpromazine 50

    2 July 2008 at 5:40 pm

    I pay $4000 a year for ACC cover that is inadequate (3/4 ave wage, accident only,lengthy poor disputes process) ACC cover is so poor I have to pay privately on top for extensive sickness, disability etc cover. And the premium is an astronomic $800 per year! For far superior cover! Oh I’m an ACC acreditied health provider so I know exactly how poor ACC is. I want a choice, not a monopoly.
51. burt 51

    2 July 2008 at 5:50 pm

    Chlorpromazine

    If ACC (as an entity, not a monopoly) offered competitive cost/cover offerings – would you use it?
52. Proctor 52

    2 July 2008 at 5:50 pm

    One of the important things about ACC which – and I may be wrong because this is a popular (read: contentious) thread – has been mostly overlooked – is that it is a no-fault scheme. Which is wonderful because we don’t have all the health-insurance litigation that carries on with other companies. Other insurance companies – like they were prior to ACC – will be at fault.

    So while premiums may be cheaper (and I wouldn’t bet on it – insurance companies know how much employers are willing to pay after analysing the ACC data) – you do have to factor in the additional costs of liability insurance.

    I’d certainly be after more than the standard $1mil business liability package.
53. Chlorpromazine 53

    2 July 2008 at 5:55 pm

    Burt. Yes I would. But at the moment the ACC cover is poor (accident only, what about my heart attack?)very expensive and my business would fold in the event of me being unable to work if I had to depend on ACC. Medical Assurance Society provides me with much better cover (sickness etc), at a much much lower cost.
54. Lew 54

    2 July 2008 at 6:29 pm

    Chlorpromazine: I guess that you’re one of the `good’ clients who’d be cherry-picked by private providers under a two-tier scheme.

    L
55. Chlorpromazine 55

    2 July 2008 at 6:40 pm

    Thanks for the sympathy Lew. ACC is doing the $4000 cherry picking. I just want value for money, and to be able to choose my insurer. Sorry to sound so unreasonable.
56. travellerev 56

    2 July 2008 at 6:57 pm

    Tane and Iprent,
    I hear yah.
    I’ll just do the occasional time in purgatory, it’s good to know you are there to save me. LOL.
57. Matthew Pilott 57

    2 July 2008 at 7:26 pm

    Chlorpromazine – it is, after all, “Accident Compensation”. There’s a wealth of private health insurers out there should you wish to use one. Isn’t your private cover cheaper because it doesn’t need to cover what is covered under ACC?

    Burt – perhaps you’ll move out of the “it’s a post from Matthew Pilott – it must be an attack” mode. It wan’t an attack, I gave a few reasons why I thought a monopoly was desireable, if not essential, in this market. Which is what you then complained I ignored. Odd. All I can see is that I could have made it a bit more clear by saying “state monopoly cover” but since that’s what we have at present I didn’t think it was necessary.

    But if you can stop assuming everything is “Labour good, National bad” over here I might have a bit more time for you.
58. andy 58

    2 July 2008 at 7:28 pm

    Chlorpromazine

    Without ACC as a back stop, do you think that you would pay significantly more for the same cover?

    Without the no fault backstop, who is to say your private provider does not charge you $10k per year.

    The same can be said of private health insurance, they can offer $20 per month premium because if your case falls into the too hard basket they push you into the public health system at no cost to them, the insurer.

    You know your cost is $4k with ACC and you know you get poor service, i.e these are know, knows.

    Without ACC can you guess your premium, would a private provider charge you more or less, this will directly affect your business model.
    i.e you know your premium will change but it is unknown by how much, known unknowns.

    this to me is the problem, the known (change in premium paid and cover provided (loss of no fault)) and the unknowns (risk of premium rise and change of business model, and specifically for a health provider extra cover for malpractice action).

    I guess what I am trying to say is that there is a leap of faith to privatise without some forward looking data on risk and cost broken down by industry/profession/personal health/hobbies…
59. Chlorpromazine 59

    2 July 2008 at 7:36 pm

    I see your point Andy but I still feel rorted. I’ve worked in six countries and NZ is by far the most expensive to insure myself in.
60. andy 60

    2 July 2008 at 7:56 pm

    I’ve worked in six countries and NZ is by far the most expensive to insure myself in.

    Price can also be a function of the size of the market and the amount of risk that can be spread.

    My concern is do we drop a functioning system, albeit average in outcomes for a system that needs to bed down over years to properly access risk.

    once again, known unknowns.
61. Lew 61

    2 July 2008 at 7:57 pm

    andy: Your points about the no-fault backstop and universal public healthcare are sound. Is the Rumsfeld reference intentional?

    Chlorpromazine: I don’t mean to sound unsympathetic; I’m just looking at the situation dispassionately. My entire argument is couched in terms of a social good which exceeds the cost of a structurally unfair system, which is basically the only justification for an ACC-like scheme.

    Curious anecdote about NZ being the most expensive place to insure yourself in. Other anecdotal evidence I have come across suggests it’s much, much more expensive (and more hassle) in practically every other country in the world.

    L
62. jbc 62

    2 July 2008 at 8:33 pm

    Lew: your argument of “a social good which exceeds the cost of a structurally unfair system” I can agree with when it comes to individuals, non work-related accidents and sports injuries, etc.

    However workplace insurance is another story. The present system has safe employers subsidising the riskier practices of less safe employers. I don’t see a lot of social good in that.

    If the present system enables our wood & fish exports to Asia to be slightly cheaper then it also makes some other export slightly more expensive.

    In the end someone pays for the risk – moral hazard is an issue with workplace insurance.
63. burt 63

    2 July 2008 at 8:56 pm

    Chlorpromazine

    I have found that peoples opinions on ACC are almost always polarised. The general trend I see is if people run businesses see the real cost, they see it accounted for in their payroll and accounting systems. People who are on salary/wages often have no real idea at all of what it costs but just love it to bits.

    I sometimes work on the assumption that when something is well supported by people who don’t know how much it cost and regarded as too expensive by people who pay for it, then it may well be a good system – but it’s simply too expensive.

    My opinion is its luxury stuff really, hard to justify when you are slashing people off hospital waiting lists. Great, I can crash my mountain bike and pay a pittance for the service I eventually get at A&E, but meanwhile people are not getting life saving operations. Go figure!
64. andy 64

    2 July 2008 at 9:16 pm

    Lew

    Ha ha, did sound Rumsfeldian 🙂

    Have just read The Black Swan:the impact of the highly improbable.

    Well worth the read.

    Burt

    I see the costs, and don’t love it to bits. Its a bugger of a system. The worry is that if we replace it with one that has worse outcomes its a negative for society as a whole..
65. burt 65

    2 July 2008 at 9:29 pm

    andy

    I’ve got the ‘worse outcomes its a negative for society as a whole..’ concept onboard. I get that bit. But I think its not something that has to be as all encompassing, so generic, one size fits all.

    Look it’s great I can take the mountain bike out and bust myself up from time to time not worrying about the costs of the panel beating. Brilliant that sounds convincing – now ACC is sounding like a great system. But hang on, the mountain bike cost how much? The shoes and the cool egg beater pedals – how much? The speedo – how much did ya pay for the wireless one? Hey GPS would be cool, could map my rides, thank god the panel beating is free because now I can have heaps of toys when I bust myself. No fault is a great concept, but show me a high risk sport that hasn’t got expensive toys…

    So what do we do? How much of the ‘its expensive’ is solely related to the fact it’s a monopoly and how much is related to the fact its a no fault system?
66. burt 66

    2 July 2008 at 9:38 pm

    … “a high risk sport that hasn’t got expensive toys “

    Rugby… Bugger, OK so we have free A&E cover for players registered (and actually playing) at Rugby clubs because it’s the national game…. Fair exception.
67. Lew 67

    2 July 2008 at 10:32 pm

    jbc: Yes, you’re quite right about the moral hazard, and this point also underlines Burt’s points about state monopolies not having an incentive to maximise efficiency, and about the beneficiaries of the system being thrilled with it, while those paying into it (employers) aren’t so.

    I agree above that there’s a case for industry premiums to be closely matched to their actual cost. It depends how far down the rabbit-hole you want to look, though, since the employer levy is paid as a proportion of wages paid, not per FTE, per hour worked or per other unit of actual risk. Is a worker earning $40 per hour twice as high a risk as a worker in the same industry earning $20 per hour? Clearly not. What this means is that since the most dangerous jobs such as forestry are also poorly-paid, levies in those industries would have to be astronomically high on a per-dollar basis in order to cover their full cost, with obvious flow-on effects. In a sense this cross-subsidisation is so structural that to argue that it’s unfair is to beg the question. The system is predicated on cross-subsidised risk. That’s just how it is, and another cost of civilised society, like taxation.

    burt: Once you make exceptions for rugby, you’re on a slippery slope…

    Ultimately I think any cross-subsidised system which provides the sort of universal cover ACC does will be considered too expensive by those paying into it, due simply to the fact that they are paying. The fact that employers are paying is a matter of compliance efficiency, and not an issue of competitive disadvantage since all NZ employers within an industry face roughly the same burden.

    The calculation you have to make is whether the cost savings which could be gained by competition and the transference of the moral hazard that brings is worth the deleterious effects in my original analysis: cherry-picking, degradation and eventual privatisation. Not to me, and not to most non-employers, I bet. The only way it becomes tolerable to me is if someone can give me a good analysis of why it wouldn’t happen, and nobody yet has.

    (There’s also a Marxist argument to be made here about the difference between employers and employees, but I don’t think I need to make it 🙂 )

    L
68. burt 68

    2 July 2008 at 11:37 pm

    Lew

    As long as Chess players don’t mind subsidising the lifestyles of people like this, then one size fits all is fine.
69. Draco TB 69

    2 July 2008 at 11:38 pm

    I won’t generally support a monopoly on anything with the natural exception of Govt itself.

    There are natural monopolies – hell, even Milton Friedman was willing to accept that fact and he stated that such monopolies must be in government hands. Roads, Power reticulation, Telecommunications, etc. The question is ‘Is ACC an natural monopoly?’ and I’d say that it is. Privatized health systems around the world invariably leave the people who most need cover without it simply because it costs too much.

    The present system has safe employers subsidising the riskier practices of less safe employers.

    That’s how insurance works – doesn’t matter if it’s public or private or even if higher risk clients pay more or not.

    My opinion is its luxury stuff really, hard to justify when you are slashing people off hospital waiting lists. Great, I can crash my mountain bike and pay a pittance for the service I eventually get at A&E, but meanwhile people are not getting life saving operations. Go figure!

    Elective surgery isn’t life saving and ACC isn’t a luxury. Bringing people back up to full health as fast as possible benefits the whole community in improved productivity.
70. jbc 70

    3 July 2008 at 12:08 am

    The present system has safe employers subsidising the riskier practices of less safe employers.

    That’s how insurance works – doesn’t matter if it’s public or private or even if higher risk clients pay more or not.

    Not quite. If any clearly identifiable segment of an insurer’s customer base turns out to cost them money in the long run then their actuaries will be on the case. Premiums will adjust to cover the risk. Try buying a couple of million dollars of term life insurance and see how detailed the questions about your life will be.

    Sure, insurance is all about averaging risk – but insurers are not stupid.

    I understand that is one reason behind those against opening to private competition: actuaries taking a closer look. Premiums being adjusted up and down to closer reflect risk and giving safe employers a break.
71. burt 71

    3 July 2008 at 12:12 am

    Draco TB

    You gotta laugh, you defend hospital waiting and by implication people being dumped off them, sent endlessly back and forward to their GP for assessments, while at the same time you justify ACC by saying;

    “Bringing people back up to full health as fast as possible benefits the whole community in improved productivity.”

    An intellect rivaled only by garden tools.
72. jbc 72

    3 July 2008 at 1:05 am

    Lew 10.32pm, [sorry – reading backwards] point taken about cross subsidisation. Bottom line for me is that employees are fully covered for workplace injuries – and that employers take all reasonable steps to minimise those injuries.

    Perhaps if private insurers looked at workplace insurance then the premium would shift to something more sensible like per FTE. You raise an interesting point there: the present levy system effectively puts downward pressure on wages in high-risk jobs[??]. Now that’s bad.

    I guess I’d tilt things further in favour of cost following risk.

    There are other areas where compulsory insurance and private companies have not resulted in actuarial Armageddon. Perhaps a teenager in the UK wanting to buy a WRX Evo XX turbo 4WD penis enlarger might think otherwise.
73. Lew 73

    3 July 2008 at 11:41 am

    burt: “As long as Chess players don’t mind subsidising the lifestyles of people like this, then one size fits all is fine.”

    I thought we’d already settled the social good part of individual universal cover?

    jbc: “Bottom line for me is that employees are fully covered for workplace injuries – and that employers take all reasonable steps to minimise those injuries.”

    Those are my bottom lines too. I see you’re arguing a system which rewards employers who work aggressively to make their workplaces safe. That’s reasonable.

    “the present levy system effectively puts downward pressure on wages in high-risk jobs[??]. Now that’s bad.”

    I agree, but the idea of tying levies to claim cost without changing the unit of risk is even worse for these high-risk industries. It might be worth considering if the unit of risk is change to per-hour or something like that, but this would bring major compliance issues, and would lead to employers under-reporting hours (as we under-reporting of wages already happens in many high-risk industries).

    But it doesn’t follow that introducing private competition would necessarily improve any of this; what we’re talking about is internal reform.

    L
74. Hoolian 74

    3 July 2008 at 12:30 pm

    Another crappy analysis from the ideologically-stuck Pierson. One must give him a bonus point for his consistent hatred of John Key. You can almost hear Pierson spit with disgust as he types. While I am increasingly of the mind that posts on the Standard are not worth negating for their sheer level of inaccuracy and feebleness, I can’t help but correct, yet another, poorly constructed argument purely on the basis that Pierson’s ego needs deflating.

    The report by ML does not say that National will privatise. Rather they think they will, and think they ought to. It is not the same thing. ML wants National to “privatise” because it is in their best interests for National to do so; this does not mean that National is hiding its ACC policy. Pierson is convinced that because Key hasn’t personally provided him with a pre-released copy of Nationals policy (on anything), therefore National must have none. It’s a simple world according to Pierson.

    If Pierson had bothered to take any neutrality in his political scrutiny, he would have realised that National has consistently promoted “opening up competition in ACC”, since well before 1999. In fact it has appeared in every election manifesto, and is not really a surprise to anyone that it might be in the 2008 one.

    Furthermore, National has never used the word “privatisation”. There is a monumental difference between Key’s stance of “introducing private competition” and “privatising” ACC. If you can’t tell the difference, please, for the love of God, don’t say anything.

    But you see, Pierson is totally opposed to competition of any kind and would rather that ACC costs billions of dollars to the tax-payer (of which he is not one), without giving NZers a choice. Choice is bad; choice is overrated. He cannot bring himself to respect people’s choices that differ from his own. Pierson despises choice because it leads people away from his perpetually saint-like Government ultimately he hates choice because people would not choose Labour.

    The only good thing about this post – is that Pierson didn’t mention Cosby-Textor once. Congrats!

    Take a page from Kiwiblogblog’s book, and bite the dust, Pierson.
75. burt 75

    3 July 2008 at 12:37 pm

    Lew

    I agreed that we were not going to agree on monopoly vs competition, I’m exploring the inequities of the ‘no fault’ component.

    One of the risks I accept every time I jump on my mountain bike and head for the hills is that if I stack the bike badly enough I’ll have a repair bill. If I take a winger and land on my head leaving my helmet a bit munted I’ll need to replace it. Bang – $200 !

    If I munt one of my wheels by stacking into a rock/tree then Bang – $300 !

    Would you think it’s unreasonable if I had perhaps a $50 part charge at A&E because I had voluntarily engaged in a high risk activity. Or perhaps a $200 year loading on my own private insurance compared to the a person whom plays chess for their hobby and has a risk profile that is vastly different to mine.

    Hey I’m putting my hand up here saying my risks are my responsibility, how can we say that is wrong? I understand that some people want to spend thousands on their mountain bike and say they can’t afford a loading on their insurance costs but IMHO they are being selfish and unreasonable. It would be like them saying that insuring their $140,000 car should be the same cost as insuring a low wage persons $3,000 car The person who would suffering here is the one who has the $3,000 car, do we really want that situation happening under the banner of protecting the people who can least afford insurance?
76. Matthew Pilott 76

    3 July 2008 at 12:40 pm

    Hoolian – way to blow in at the end and make an argument that’s already been shown up.

    Burt – honest, non-attacking question. Do you think such differentiation can be built into the system without adding costs (bureaucracy…) so as to simply increase the overall price to a point where low risk people pay the same, and high risk people have to pay more?
77. Lew 77

    3 July 2008 at 12:51 pm

    burt: I wouldn’t be averse to such a system, provided that nobody is ever denied care or cover based on their inability to pay. This would, in a pure sense, make something of a mockery of the system and would punish two classes of people: 1. those who are honest enough to declare all their dangerous hobbies (in the case of annual loading); 2. those who can afford to pay (in the case of co-pay).

    Still, the system could still work as a disincentive to do stupid things, but only for those who can pay. Since that will be most people, I think it’s worth considering. However, as Matt says, this would make the system complex and prone to being rorted.

    Additionally, it’s a slippery slope since the co-pay, loading or whatever would have to be very tightly constrained in order to ensure that most people could still pay, and that nobody was denied care.

    L
78. burt 78

    3 July 2008 at 1:20 pm

    Lew/Matthew

    I’m not even going to try and design a system that could cover all of the concerns. However that isn’t to say that it’s impossible or even very difficult, just it will take hours to discuss in this forum and probably not get far past the “but…, how come…” stage.

    I just look at it and say that the risk of a broken arm is extremely low in Chess (sure a fight could break out, punches could be thrown etc.. but it’s not likely) but the risk of busting an arm are pretty real on the mountain bike.

    I totally agree that ensuring low/no wage people should never be turned away from A&E with an injury because they can’t afford insurance is something we should never let happen in NZ. Perhaps they get a bill form A&E and claim it back from MSD if they earn below a threshold . I don’t know the answers to this.

    But how do you claim you “can’t” afford insurance when an “accident” happened while going hard out on a $2,000 mountain bike wearing about hundreds of $$$ worth of mountain bike kit?

    My underlying take on it is that we should all be responsible for ourselves as much as we can. Accidents do happen, but busting myself on the mountain bike isn’t an accident – it’s a consequence of my decisions to ride in the hills. Tripping over the cat and splitting my face open on the doorway is an accident, but it wouldn’t be an accident if I had been drinking like a fish, it would be a consequence of my decision to hit the bottle Do you see where I’m coming from?
79. Lew 79

    3 July 2008 at 1:42 pm

    burt: That you’ve affirmed the principle of universal care means we’re at least capable of having a reasoned discussion about it. The problem of implementation will always be bigger than the problem in principle with these things – this is why we employ all those bureaucrats between Molesworth and Featherston.

    L
80. burt 80

    3 July 2008 at 2:06 pm

    Lew

    I’m not affirming universal care, I affirming our social responsibility to help people who cannot help themselves. I’ll make this F-ing obvious for you.

    If a beneficiary (especially a long term one) turned up in A&E with a neck injury from stacking their jet ski into a wharf then two things should happen;

    a) The get a bill if they can afford a jet ski they can accept the risk of using it.
    b) Set the welfare auditors onto them asap.

    I also find it intriguing that when the solution to this is less bureaucrats via private options (choice) you hide behind the “more bureaucrats” facade. Very sad.
81. Lew 81

    3 July 2008 at 2:32 pm

    burt: Easy, easy – I’ve not been on the offensive, no need to take the defensive.

    I think you have affirmed the principle of universal care in that people get treatment in the first instance, regardless of the ability to pay. In some privatised systems (notably the US) this isn’t the case by any means. On the question of eventual payment, I still tend to believe care should be free or very close to free for everyone, but I can concede your points about the ability to pay and the acceptance of risk.

    And, I didn’t mean to imply `more bureaucrats’ at all – my point is that that’s why we have policy people – because they can solve implementation problems, it’s their job.

    L
82. burt 82

    3 July 2008 at 3:23 pm

    Lew

    There are two separate issues, people who cannot pay and people who simply don’t want, or need, to take responsibility for their own actions so they don’t. Sorry I thought you were saying they are one in the same because everybody gets care one way or another.

    I guess what I’m saying here is that something like a “community services card’ should not be in the same wallet as a platinum card 🙂
83. Lew 83

    3 July 2008 at 3:40 pm

    burt: “I guess what I’m saying here is that something like a “community services card’ should not be in the same wallet as a platinum card”

    I quite agree.

    L

Links to post

1. Time to front up on ACC at The Standard 2.01: posted on 3 July 2008 at 11:53 am
2. Nats’ NGO policy, give the money to Aussies at The Standard 2.01: posted on 7 July 2008 at 1:09 pm
3. The Standard Week: June 27-July 4 at The Standard 2.01: posted on 7 July 2008 at 9:07 pm
4. The clean man at The Standard 2.01: posted on 8 July 2008 at 9:22 pm
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9. The Standard line: ACC at The Standard 2.02: posted on 14 October 2008 at 5:05 pm
10. Afghanistan, a lost war and the low morale of the troops that have to fight it. « Aotearoa: a wider perspective: posted on 29 October 2009 at 11:17 am

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