Workers Compensation in NSW and Victoria- ‘Immoral and Unethical’ – 4 Corners Exposes It. 28/7/20

This is what I have been saying for years. If you think the banks are bad, you have not dealt with insurers. They will do anything rather than pay people’s legitimate medical and living expenses.

My poor patients literally starve. They change their addresses each visit as they couch-surf their friends. The foreign patients with no Medicare cannot even get GP treatment, and because they are often paid sub-award wages in cash cannot even prove their incomes. Most specialists simply will not operate for the Medicare rebate, and even if they will the waiting time is a year. I tell the patients where the soup kitchens are. They are in huge pain and the most I hear from governments are warnings that they have been on narcotics too long, as they wait for the surgery that the insurers have refused to pay for.

The patient Scott with his supportive wife, at the beginning of the 27/7/20 4 Corners tells the story of his shattered life, which is just like what my patients tell me.

The Victorian the Ombudsman, Deborah Glass did an investigation into WorkSafe Victoria, the callous government insurer there. She found appalling behaviour and says so very clearly.

In NSW it is the same- the appalling, hopeless iCare, who should be called ‘I Don ‘t Care’ put together a bunch of insurance executives who had no experience in working with people. They all got awarded huge salaries and set about having computer algorithms to replace claims clerks. So when a claim goes wrong (which takes a while to figure out as 3 week delays are pretty much the norm), you call and ask to speak to the case manager. You can’t. But if you persist eventually you find one, but he or she only got the claim yesterday. i.e. There had been no person managing it until you hassled like hell, and it is often refused anyway.

Meanwhile the patient had no treatment and the fat cats at the top had not noticed that their system had a few glitches. And most of the concern in both the management echelons and the media is about some financial deficit which, if we are to believe the totally out-of- touch iCare CEO, Ken Nagle, depends how you do the accounting.

No one seems to remember that this is just a health insurance scheme to help Workers’ Compensation and Motor Vehicle accident Victims. If Medicare worked it would be completely unnecessary, and it cannot even manage to function like a private health insurer. It assumes that all doctors are crooks who cannot be trusted to order just the tests and operations necessary- they all have to be evaluated and denied by insurers who get every dollar that they refuse to pay, and who seek out dodgy doctors to carry out ‘Independent Medical Examinations’ (IMEs) to deny normal treatments. If the IME doctors do not do what the insurers want they get no more work from them.

The directors and top executives of iCare should be sacked and the whole thing given to ICAC to examine. ICAC needs more resources also.

SIRA (State Insurance Regulatory Authority) has been more hopeless than ASIC and APRA were with the banks, and should be abolished also. This story came from a whistle-blower, not from SIRA, the responsible agency, though some of us have been trying to get SIRA to act for years.

SIRA became a bit more interested after the Hayne Royal Commission into Misconduct in the Banking, Superannuation and Financial Services Industry reported in February 2019, presumably as they realised that if the Commission has been given enough time to look at insurance, they would have had their own hopeless regulatory efforts scrutinised. They had an internal investigation, the Dore Inquiry (no, you almost certainly have not heard of it), but it did actually find that iCare was behaving appallingly. The report release was delayed 5 months (July-December 2019) and released just before Christmas with iCare’s reaction, which was to admit that they had made ‘mistakes’ and that they accepted all the recommendations. Great PR! Released on a busy day to avoid scrutiny and if you as a journo were a tiny bit interested, there was no story because iCare accepted the changes suggested. The SIRA strategy worked- no scrutiny of either iCare or SIRA.

At last there is a 4 Corners on this! Watch it if you missed it!

Let us hope that when it goes to ICAC some major changes are achieved. It seems that 4 Corners is the only regulatory force in the country. I guess that is why the government wants to de-fund the ABC.

https://youtu.be/fxIvKogrE2Q