Tuesday, May 27, 2008

Not too sick to bully

The Dominion Post reports today that some GPs are being bullied by "sickness" beneficiaries particularly in smaller provincial areas, as they seek medical confirmation they can't work:
Dr Van Herck said... "He had seen one woman who had been on a sickness benefit for 19 years because of asthma but smoked a packet of cigarettes a day. Work and Income had offered her several quit programmes. "She admitted she was too lazy to go." Another sickness beneficiary's documented reason for not working was they "could not be bothered".
He continued..
"On the day he saw the asthma sufferer, he also saw a man whose leg had been amputated above the knee and who worked full-time, despite pain. Another woman continued to work after a stroke."
Here is a simple solution. State that as from a certain date, there will be no new eligibility for the sickness benefit, but that people can then buy sickness insurance from insurance providers. The sickness insurance no doubt would reward healthy lifestyles, and penalise smoking, lack of exercise, high cholesterol and the like.
Of course taxes would be cut to allow people to afford this.
Existing sickness beneficiaries would be given a year to get well, by that time they would either be deemed invalids or be transferred to an insurer, which would manage the government's liability for the person. Clearly anyone who continued to engage in destructive behaviour (e.g. smoking with asthma) would no longer be paid.
Of the political parties, Labour supports the status quo, the Greens want to increase benefits, National might have a policy and ACT wants to shift the system to compulsory insurance. Libertarianz would abolish the sickness benefit.
Of course some of us wonder how so many people are never too sick to commit crimes.


richard mcgrath said...

I can back up what Dr van Herck said. A lot of people are on sickness and invalid benefits because they have destroyed body and mind with drugs, alcohol and cigarettes (medical diagnoses = hepatitis C with chronic liver disease, alcoholic cirrhosis, Korsakoff's psychosis, emphysema, etc). And yes, Work and Income employees are instructing some people to get a doctor to certify them when it isn't their (the WINZ employee's)call.

I have certified many people off as chronically sick or as invalids but I always encourage them to seek work. In reality they get only slightly more than the unemployment benefit but are allowed to work part-time so there are some advantages over being officially unemployed. Of course, these people also don't appear in the stats as "unemployed".

Well spoken Dr van Herck.

john-ston said...

Liberty Scott, what you forget is that a significant proportion of New Zealanders, for whatever the reason is, would not be able to afford the sickness insurance, no matter how healthy their lifestyle - not even with tax cuts (which would probably be a pittance, getting rid of the sickness benefit would probably allow for a cent in the dollar tax cuts). Just look at the States, where there are fifty million people without health insurance because they cannot afford it. Further to that, the people that would miss out are the bottom of society; the same people that have enough health problems as it is (look up the statistics, generally, the poorer you are, the worse your health is).

Anyway, why are GPs bending over to these people? Don't they have any backbone or something?

richard mcgrath said...

John-ston - under a Libz government, annuities would be set up from the sale of state owned assets to guarantee coverage of medical costs for the already genuinely disabled. For five years money would be spent on all other New Zealanders setting up health insurance, and then it would be up to people to keep this going themselves, using their massive tax cuts (first $50k tax-free, 25c tax on each dollar after that for 5 years, income tax abolished after that, GST abolished immediately).

The fifty million Americans without health insurance is a debunked myth.

From an article in the New York Sun, 24/9/07:

According to the U.S. Census Bureau’s August 2006 report on “Income, Poverty and Health Insurance Coverage”:

45 million Americans have no health care insurance, but:

- 9 million (20%) of these people are foreign nationals

- 9 million (20%) of them are actually covered by Medicaid (insurance for the poor)

- 9 million (20%) of them earn over $75,000 p.a. and have opted out of insurance

- 8 million (17%) of them earn between $50,000 and $75,000 p.a., as above

- This leaves 10 million (3.3)% earning under $50,000 p.a. uninsured, many of whom are healthy people aged 18-34 (who number 18 million of the uninsured in all the categories).

A lot of people at the "bottom of society" have put themselves there. Smoking is a lower socio-economic group phenomenon. Drug taking is the same. I have seen several people with every economic advantage put themselves at the "bottom" through drug use.

GPs probably don't have the "backbone" to say no for two reasons - in general they have a natural desire to help people, even if this is misguided sometimes; and secondly they don't want to get pinged to the Health & Disabilities Commissioner by an angry patient(which costs the complainant nothing but costs the doctor a lot of anguish).

john-ston said...

Mr McGrath, a Libz government would see us return within a decade or two to a type of society that was found in Victorian England; one where the vast majority were born poor, and were screwed for the rest of their life. In case you have forgotten, many of New Zealand's cities (New Plymouth, Wanganui, Wellington, Nelson, Christchurch and Dunedin) were founded by people who wanted to create a society that did not have those ills - to build a Jerusalem in the Antipodes

Not even massive tax cuts will do; a person on the minimum wage (which they would be lucky to get once it is gone), would only get $5000 back from the government if taxation was abolished; at the low scale, it would cost $2000 per year to educate a child under a market system; and health insurance I could imagine would be approaching the $1000 per annum mark. Of course, this is before one considers that wages would fall (and that would breed high levels of unionism, but of course, employers may make people sign contracts prohibiting them from joining unions, like what happened in the 19th Century), and take away many of their earnings.

Also, while I do agree that some people at the bottom of society have put themselves there, others have been stuck there; when you go to school without eating breakfast, you are unlikely to learn now, are you? Without a solid education, you are pretty much stuck in a low wage unskilled job.

Also, about health; the nine million under Medicaid would not get it under a libertarian government; remember that item of 'nanny state' would be gone by lunchtime. On top of that, how can you be sure that the 17 million have opted out of insurance? Did they tell you?

To close off, yes it is unfortunate that GPs would be pinged by the Health and Disabilities Commissioner, but then, you would agree, there is a need for their scope to be fixed.