Wednesday, January 16, 2013

When big business dabbles with welfare; a cautionary tale

unum

“Jack Gilligan, who was the Democratic governor of Ohio… said ‘You know there will never be democracy in America when big business can buy both parties and expect a pay-off, whichever one wins. And you know, a touch of that may possibly have spread in this direction.” Tony Benn.

I have been researching the relationship between US insurance giant (and lawbreaker) Unum and successive UK governments - Conservative, New Labour and Coalition – and the minimal research I have managed so far tells me that, if there’s one thing the Labour Party needs to do to ensure its electability in 2015, that thing is the expulsion of Unum and all private insurance firms, their subsidiaries, partner companies, and people who have worked with or for them, from any position of influence. Kick them right out!

Any government that fraternises with these vampires puts corporate profits above the well-being of its citizens. That is clear from what I have read. I want to go into certain aspects in detail, but before that, you deserve to know the details, so I’ve written a little story for you:

Once upon a time, a big insurance company had a little problem. It had been making money hand-over-fist by investing people’s premiums in high-interest portfolios, but interest rates were falling and new kinds of ‘subjective illness’ had arisen, for which medical science was not prepared – ‘chronic pain’, ‘chronic fatigue syndrome’, fibromyalgia, multiple sclerosis, Lyme disease.

The solution devised by the bosses was to reduce the number of successful claims it paid out, by aggressively disputing whether the claimant was ill. So the company skewed its medical examinations to its own favour by questioning illnesses that were “self-reported”, labelling some disabling conditions as “psychological”, and playing up the “subjective” nature of “mental” and “nervous” claims.

“Sickness is temporary,” they said. “Illness is a behaviour – all the things that people say and do that express and communicate their feelings of being unwell. The degree of this behaviour is dependent on the attitudes and beliefs of the individual, as well as the social context and culture. Illness is a personal choice.” In other words: “It’s all in the mind; these people are fit to work”.

Around the same time, a small country had a big problem with people claiming out-of-work benefit because they were ill. This was not a problem because they were lying about being ill – fraud amounted to less than one per cent of claims. Nor was it a problem because too many people were claiming – benefit levels were among the lowest of any countries nearby, and claims were on a par with those other countries.

No, the problem was that the man running the system, whose name was Peter**, wanted to make money out of it.

So he hired the boss of the big insurance company, whose name was John***, and asked him to help out. John said, “We have a great test that you can use! Instead of asking whether someone can do their job, you assess their general capacity to work, with a series of – we call them – descriptors. One could say the person ‘Is unable to cope with changes in the daily routine’, ‘Is frightened to go out alone’. Then the results get passed on to different people – adjudication officers – who judge whether they deserve your benefit. But the clever bit is that these officers aren’t doctors – the customer might be saying they’re sick but medical evidence has nothing to do with what the test is about! We’ll train your adjudicators – for a price. We’ve even got a sexy name for the test: It’s bollocks!”*

Off went Peter to try it and, lo and behold! The rise in claimants came to a halt, as if by magic. But it wasn’t magic. It was bollocks.

Meanwhile, the insurance company was making out like a bandit. Not only was it now at the heart of the small country’s government, it was able to make money from the claimants as well. Before the new rules came into effect, it advertised for customers, saying the new system meant “if you fall ill and have to rely on state incapacity benefit, you could be in serious trouble!”

Before long, the big insurance company found it was even bigger, with a quarter of all its post-tax income being paid by people in the small country.

Meanwhile, back at home, people had started to complain about the big company. It was a big, NASTY company, they said, because it had forced them to accept less when they claimed than their policies offered. The government there found that the big company had relied too much on in-house professionals; had constructed doctors’ or examination reports unfairly, for its own benefit; had failed to evaluate claimants’ conditions in their totality; and had placed an inordinate burden on claimants to justify why they should receive the benefits for which they had paid. Many claims were found to need re-examination.

That did not make a scrap of difference to the people running the sickness benefit system in the small country that had asked for the big nasty insurance company’s help. An election had happened and Peter had been asked to leave, but the new people in charge, Frank**** and Tony*****, were keen to capitalise on what had gone before and transform their welfare system into a new marketplace – a source of revenue, profitability and economic growth.

With help from the big nasty insurance company, they decided that the solution was not to cure the sick – or even to prevent their sickness in the first place – but to convince them that work is therapeutic, aids recovery and is the best form of rehabilitation. In other words, bollocks*. This way, with the help of the big nasty company’s bollocks* tests and adjudicators who based their decisions on bollocks*, they could say the problem was with the person who had the illness. Their behaviour and beliefs became the focus of the government’s moral judgement and action. If they did not change their ways, then sanctions would be used as a “motivational tool” – and people would be starved back into work.

And that, dear child, has continued to this very day! People claiming sickness or disability benefits in the small country, which is called the United Kingdom, have to take a test in which medical evidence plays a tiny role, run by people who are not doctors and judged by people who are not doctors. Many of these decisions have been found to be unfair, and have often been found to have failed to evaluate claimants’ conditions in their totality – which is why people with terminal cancer have been found fit for work. Many claims have been found to need re-examination.

You can see the hand of the big nasty insurance company at work, can’t you!

That is because the big nasty insurance company, which is called Unum, has been at the heart of the small country’s government ever since it was first invited in. And they intend to live happily ever after, at the public’s expense.

“A lot of people think that disabled people don’t have sex, but this is not true, because the government are screwing us hard.” Francesca Martinez, The News Quiz, BBC Radio 4, January 11, 2013.

*I should apologise for the fault in my computer. Every time I try to type – I’ll just cut and paste it in here – “the biopsychosocial model” or any combination of those words, it comes out “bollocks”. Sorry!

**Peter Lilley
***John LoCascio
****Frank Field
*****Tony Blair


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