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Source: The Melbourne Age [Letters to the Editor]
"...The Age 19 October 2003
Spot on
Kenneth Davidson, and Bronwyn Morkham (16/10) are both spot on: Tony Abbott has to take a serious look at introducing a no-fault compensation scheme in Australia for a variety of reasons (not least the medical indemnity issue). Our current system leaves young people in old age nursing homes because the cause of their disability isn't "worth" enough money to get them out.
Do Australians really value our current system, which benefits insurers and lawyers more than the individual seeking appropriate health care and services? I doubt it.
Sally Shaw, Warranwood ..."
The Age 17 October 2003
Challenging our 'right' to a 'gold can'
The indemnity problem is not only political, as Kenneth Davidson says (Opinion, 16/10), but cultural. Australians have been conditioned over the past 40 to 50 years to the belief that a pot of gold can, and should, ease the pain of every injury. It began with large lump-sum awards for common-law claims under workers' compensation policies, encouraged by unions and their advocates, and spread from there into all fields of activity.
More than 20 years ago, at seminars and conferences, I listened to eminent lawyers explaining how unfair it was that people who suffered injury away from the workplace (and not in a motor vehicle) should not have access to large sums of money. These lawyers intended to help them find someone to pay. For the common good, of course. This is now our culture: someone must pay.
Davidson proposes a practical solution which, as he says, seems obvious, though probably not to the present Government. The cultural problem would remain, and the lawyers, insurance and investment industry types, bureaucrats and even politicians who live off our tort-law system, will not try very hard to change it.
Bob Emsell, Eagle Point
The Age 16 October 2003
No one's fault, but we're punished
It was good to see some talk about a no-fault scheme for injuries in yesterday's Age (Kenneth Davidson, Opinion). How good it is also to see a doctor talking fairness and equity in a system that currently has little of either (Bronwyn Morkham, letters).
As a victim of a tragic and sudden long-term disability that was not compensatable in any way, my 20-year-old daughter has been hung out to dry by our present system. Despite the thousands of dollars our family pays out in TAC, WorkCover, superannuation, Medicare and private health insurance, my daughter is in a nursing home facing an uncertain future because we couldn't claim on any of them. Where is the fairness in that?
I would much rather pay a single premium to a no-fault scheme than pay five different premiums that are useless to my daughter and to us, as we now do. My daughter's accident was nobody's fault, but she and the rest of us are being punished.
If a no-fault scheme had been in operation, we would at least be able to bring her home or provide a life worth living in the community for her and get some value for money out of the thousands of dollars we have paid out in insurance premiums over the years.
Ann Newland, St Albans
The Australian 15 October 2003
Dr David Molloy (Letters 15/10) is too quick to dismiss a no fault personal injury system as whimsical.
The current search for a solution to the medical indemnity predicament is merely one aspect - albeit a currently high profile one - of a larger systemic crisis that affects all sectors of our health care system. And the Government cannot afford to be blinkered in its search for an answer.
Despite the present Government/AMA focus on the medical arena, the fundamental issue at stake is how the community looks after people who need high levels of care for life following a catastrophic injury. Democrat Senator Brian Greig acknowledges this in his call today for the Government to investigate the creation of a national no-fault insurance scheme for Australians suffering catastrophic injuries. As Senator Greig correctly indicates, even those with compensation find that their funds are insufficient for whole of life care and support.
It was reported in August by accounting firm PWC that the cost of compensable catastrophic injury and disability in Australia is $600m per year, but that only 11% of this relates to medical negligence. To spend so much money and political energy on this small portion of the system when the rest of it is riddled with inequities, duplication and wastage is short sighted and a clear waste of everyone's money.
We have a patchwork quilt of over 50 personal injury insurance schemes in Australia that are small, narrowly focused and often rely on common law to determine the long term care arrangements. Dr Molloy wonders how a no fault scheme will be paid for. Yet we are all already paying multiple premiums directly to Compulsory Third Party and workers compensation schemes, and indirectly to medical and public liability schemes. The problem is, of course, that we insure for cause, not effect.
Those severely injured people, who have their day in court and lose, demonstrate this most acutely. While this is a win for the insurer and the doctor, what then for the individual? The taxpayer foots the bill for their care and the pressure on our overburdened health system increases.
And this does not even begin to account for those injured or who acquire serious disability through non-compensable circumstances. With or without compensation, the community still pays for their care. Thousands of these people who have no one to sue or no insurance coverage for their disabilities now block our nursing homes because the system is so inadequate.
A no fault scheme would reduce this ridiculous duplication and could roll these schemes together with major savings to the public purse in the process. The Government must address this as a matter of urgency!
Dr Bronwyn Morkham
National Alliance for Young People In Nursing Homes
The Age 15 October 2003
Insurance must be fairer for all
Dr Paul Biegler (11/10) is right to be concerned about fairness in this personal injury insurance debate. In looking to solutions, we need to take a broad look at what will be fair to everyone, and minimise the trauma of disability. Focusing on blame and punishment, either towards doctors, lawyers or victims is non-productive, particularly where the causes of disability are unknown, unavoidable or irrelevant. This is where a no-fault system would provide a solution.
Major disability from any cause needs assistance from our community, and there should be equity in the distribution of care resources. Why is it that some causes such as car or work accidents are more worthy (and worth more) than others, such as disease or unavoidable misfortune?
We all pay dearly for health care and even more for insurance that may not even cover us in some unforeseen circumstances. Across Australia young people with acquired disabilities are forced into nursing homes because they have no one to sue, or because they didn't win when they tried. The insurance policy may lapse but the life-changing disability remains for life.
In New Zealand, the cost of medical indemnity insurance in their no-fault scheme comes to about $9.25 per head per year for every New Zealander. Is this because they have more competent doctors? Or is it because their system is better? It may be neither, but if Tony Abbott's indemnity taskforce is serious about finding a fair and equitable solution, it should take a serious look at the no-fault option across the disability system.
Dr Bronwyn Morkham,
National Alliance of Young People In Nursing Homes
The Age 8/10/2003
Insurance must be fairer for all
While Dr Michael Axtens makes a compelling point about the medical indemnity crisis (Letters 7/10), the medical workforce is really part of a much bigger debate about how we should manage catastrophic disability from injury and disease.
Indeed, if the medical indemnity issue is any guide, we seem to be obsessed with the cause of disability rather than the effect, and we pay dearly for it. The fact is that we have systems for injury at work, on the road, and on the operating table, all of which we pay for separately and at vastly different rates. In fact, to cover just these three causes we have almost 20 separate insurance schemes, and we pay considerable amounts for every one of them. If you are a disabled through crime, for example, you get next to nothing, and if you are injured at home or contract a crippling disease you are prey to the government budget cycle.
The problem with these small schemes is not the doctors or those that receive compensation...it is with those who don't receive anything!
Spare a thought for the person with a life changing disability who takes on a doctor in court and loses. Their catastrophic injury does not go away, and the community ends up paying for their support. This person will have paid their TAC and workcover levy as well as their contribution to medical insurance, and yet the taxpayer ends up footing the bill. We are all getting sadly ripped off by this duplication.
If we redirected the money we already pay for multiple insurances, we could well fund a national insurance scheme like the one suggested by Dr Axtens.
We cannot predict when we might need such insurance. What we can predict is that unless we do something, we will end up with a health care system that values blame and money more than the lives it was set up to save.
Bronwyn Morkham
National Alliance for Young People InNursing Homes
The Australian 8/10/2003
Calls for a national insurance scheme seem to have gathered pace recently in response to the medical indemnity crisis. Yet the medical workforce is really part of a much bigger debate we need to have about how we should manage catastrophic disability from injury and disease.
Indeed, if the medical indemnity issue is any guide, we seem to be obsessed with the cause of disability rather than the effect, and we pay dearly for it. The fact is that we have systems for injury at work, on the road, and on the operating table, all of which we pay for separately and at vastly different rates. In fact, to cover just these three causes we have almost 20 separate insurance schemes, and we pay considerable amounts for every one of them. If you are disabled through crime, for example, you get next to nothing, and if you are injured at home or contract a crippling disease you are prey to the government budget cycle.
The problem with these small schemes is not the doctors or those that receive compensation...it is with those who don't receive anything!
Spare a thought for the person with a life changing disability who takes on a doctor in court and loses. Their catastrophic injury does not go away, and the community ends up paying for their support. In Victoria, this person will have paid their TAC and Workcover levy as well as their contribution to medical insurance, and yet the taxpayer still ends up footing the bill. We are all getting sadly ripped off by this duplication.
If we redirected the money we already pay for multiple insurances, we could well fund a national insurance scheme. By making the plaintiff's right to sue redundant, a no fault scheme would also solve the current medical indemnity crisis.
We cannot predict when we might need such insurance. What we can predict is that unless we do something, we will end up with a health care system that values blame and money more than the lives it was set up to save.
Bronwyn Morkham
National Alliance for Young People In Nursing Homes
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