Reinventing ACC not healthy

Soon after his inauguration in 2009, United States President Barack Obama was asked about the kinds of issues that came across his desk. Invariably, he said, by the time anything made it to the Oval Office all of the options presented poor outcomes and he was often forced to choose the least harmful one.

That’s the nature of high office – a constant balancing of apparent inequity and the greater good.

The death of Hamilton woman Abby Hartley in Bali appears to personify this; a New Zealander felled by illness in a foreign country, whose treatment and repatriation was, in this case, not covered by the insurer.

At first glance it seems unfair that the Government did not help Hartley out, that it was generous Kiwis who stumped up. But those who wish for a government that steps in to cover every personal calamity and indiscretion; one prepared to fill the space left in the absence of personal responsibility; should be careful what they wish for.

And remember, also, the old adage: hard cases make bad law.

Sir Geoffrey Palmer wants a substantial reform of the Accident Compensation Corporation. He believes it is unfair and plain wrong that a person injured in an accident is treated more generously than one ‘‘laid low by cancer, a heart attack or stroke’’.

There is, of course, some merit in that argument. It can seem a nonsense that a person who is injured in the pursuit of high-risk adventure is covered while another who, through no fault of their own, finds themselves incapacitated by disability or illness does not enjoy the same protection.

Palmer says drawing a line between such things is difficult and unfair. He’s right.

But talk of addressing that perceived inequity skips over the potential consequences for the country, the economy and those the former prime minister supports. It also ignores how the market has moved on to help fill the void Palmer highlights.

A system covering not only injury but also illness would require many more billions of dollars in funding and levies, meaning a substantial drain on the economy and businesses that support it.

Also, many Kiwis have themselves noted the gaps and perceived inadequacies of the country’s health system and arranged health insurance. For some it is a recognition of the need for more personal responsibility.

Not everyone is able to make that financial sacrifice, and others are born with ailments and disabilities not covered by insurance.

For those people, Palmer’s concept of a ‘‘single unified system’’ would help. But wouldn’t it make sense to invest more in a robust, responsive health system that could deliver this anyway, and without the potential burden of another separate, de facto funding body taking money from surgeons, specialists, doctors and nurses?

ACC is not perfect. Far from it. Some reform is needed to make it fairer, but ACC Minister Iain Lees-Galloway should think very carefully should the Palmer option ever make it on to his desk.

The nature of high office is a constant balancing of apparent inequity and the greater good.