Falling to Bits
A while ago I blogged about ACC’s increasing propensity to call all injuries with long-term sequelae, “degenerative” (i.e due to wear and tear). Increasingly, patients are taking ACC to the tribunal (and often then on to court) and winning their case, despite ACC having an “expert opinion” from a tame specialist. Today there is an article in the Herald on just one such patient and Madeleine Flannagan over at M&M reminds us that she is going to do battle with the ACC dragon tomorrow (Good luck, Madeleine!)
Oh the joys of monopoly insurers! Oh the compassion of monolithic government!
And talking of government, the most worrying aspect of the Herald article is the reaction of Nick Smith:
“Late last year the Herald received more than 400 complaints from people about their ACC cases, many of which were declined because of supposed degeneration.
“ACC Minister Nick Smith conceded there was a “grey area” surrounding opinions on whether injuries were caused by an accident or underlying conditions.
“ACC’s success rate in review hearings declined to 65 per cent in the last financial year from 70 per cent the year before. Despite this, Dr Smith has ruled out an independent review unless the accident body begins losing a larger number of disputes.”
The worrying thing here is that Mr Smith apparently has no idea whether there is a problem with ACC claims and no inclination to find out. Over 400 people have complained to the Herald and ACC lose fully one third of all their disputed claims. Yet Mr. Smith would like “a larger number”!
How many would be big enough, Mr. Smith. Ten thousand? A Million? Would losing 50% of all claims be enough? Or will you only do something when it hits 99%? All those management seminars which told you to put a specific action or date on something didn’t do you much good, did they, Mr. Smith?
Of course, it occurs to me that the government is happy to let ACC get as belligerant as it likes. After all, they are saving the government money. And the absolute numbers of people being put in these positions is quite small, so there is little or not voting downside. Pardon my cynicism.
I can’t think of a better reason why ACC should be completely privatised. Monopoly government insurers have no place in compassionate, civilised society.
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Apr 21 11 2:14 pm
Some clients and also my aged mother have battled the ACC over the issue of degenerative injuries and lost due to the opinions of the tame specialists (generaly retired practitioners it seems) that seem to be prefered over the opinions of specialist orthopaedic surgeons and similar.
I have reluctantly come to the view that playing the man, i.e the tame specialist, rather than the ball may be an outcome of the ACC approach. By this I mean complaints to both the Health and Disablity commissioner and assorted disciplinary bodies about the conduct of the tame specialist.
Complaint proceedings generally make people sit up and take notice.
Apr 21 11 10:53 pm
You are no doubt correct. In this electronic age however, a quick check on google will often unmask these tame specialists with a history of concluding what ACC pays them to, like this one:
http://accforum.org/forums/index.php?/topic/2121-dr-kantilal-kanji/
Apr 22 11 12:36 am
I have been following Madeleine Flannagan plight for awhile and wish her the best. I am aware of a Ortho Specialist who are so insensed by some of the denials of claims by ACC they are paying out of their own pockets for the claimant’s lawyer in order to over turn the decision.
Let’s not also forget the CLINICAL REVIEW OF THE ACC SENSITIVE CLAIMS CLINICAL PATHWAY that was completed last year and found HUGE failings. http://admin.beehive.govt.nz/webfm_send/13
Minister Nick Smith then said he accepted the recommendations and set up a monitoring group to review the changes after 6 months and then 18 months. Well, the 6 months review has just been completed and the draft report is due at the end of April and the full report in May.
But what Nick Smith doesn’t know yet was at the 6 month review there was an unanimous vote of ‘no confidence’ in Dr. Peter Jansen’s abilities in the area of sexual abuse and sensitive claims by the group (a group of his peers, and the clinicians that work in sexual abuse care). Of course, lets not forget the suing of a claimant for $250,000 for calling him a fictional DSM-IV diagonisis, which in light of this ‘no confidence’ vote, could be hard for Dr. Jansen to dispute.
So yes, orthopethic and sexual abuse injuries have both been largely shafted by this Government.
Alex´s last [type] ..Is Dr Peter Jansen a CIP- or not
Apr 22 11 12:39 am
ACC shouldn’t be privatised – it should simply be abolished.
Repeal the entire Act except section 317 and any others that abolish the right to sue
in other words: there will be no ACC, no levies, no taxes, no corporation, no bureaucracy,
and no right to sue employers or other high-value, high-worth individuals and companies for injuries they nominally caused to low-value individuals…
Solves all the problems of ACC.
Apr 22 11 10:37 am
Having just paid for a family members hernia operation you could say our already jaundiced view of ACC wasn’t improved as we reviewed the pathetic reasons why it wouldn’t fund the operation.
The reality was that this extremely fit person had to go on a sickness benefit and would have been there possibly for years till the hernia got “bad” enough to constitute an emergency operation. The actual cost of the operation is dwarfed by the cost of paying the SB for years, and in a tight labour market, the unemployment benefit after an emergency op.. to say nothing of the effect on the family member and *his* young family.
What is the point of a Govt run ACC if it cannot “see” the long term effects on the Govt’s coffers if a timely operation is denied?
JC
May 17 11 1:22 pm
So, I guess what you are saying is that ACC is dishonestly rejecting claims. Well, hello, ACC is a dishonest scheme in conception and execution. It is, and has never been, an “accident” compensation scheme. It’s no-fault principle means that it was always intended to be a parallel welfare system that is doomed to failure. No-fault means no limits. Any claim upon the scheme is valid and any attempt to limit claims will always be arbitrary, and all we are seeing now is the arbitrary criteria for acceptance of claims being ratcheted up to slow the inevitable blow-out in liability. It is tough for those whose claims are being rejected but hardly surprising. It is time New Zealanders stopped believing in Santa Claus and started to realise someone has to pay.