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Much has been made of the deprivations to be faced by ordinary citizens in meeting the announced rises in ACC levies, and it is true that the impost of the additional costs on the typical family budget should not be underestimated.
The Government came to office promising to look into ACC, and the resultant shake-up, with its accompanying cost rises, should not come as a surprise.
It might have been hoped that the similarly promised tax cuts would to some degree have made up for the deficit in family incomes but, scuppered by the global recession, these did not eventuate.
Under the cost regime announced late last week, the income of the average worker with a car will be reduced by about $200.
The employee levy is set to increase 30c to $2 per $100 of earnings - an increase of nearly $150 a year for someone on the average income of just under $50,000.
Similarly, the motor vehicle levy will increase by about $30 a year from $168.46 to $198.46 from July 1, with the petrol levy remaining as it is.
The employer and self-employed levy is set to increase 16c to $1.47 from April 1.
Motorcycle riders will pay considerably more, but not as much as was originally mooted by the ACC board, the Government having found the proposed hikes to be politically unpalatable.
Be that as it may, and notwithstanding the objections by, among others, the Labour Party, that the financial problems of the ACC system - which these rate rises have been imposed to address - have been exaggerated to pave the way for elements of privatisation within it, the latest moves are cause to look again at this unwieldy corporation.
It came into existence in 1972 with the Accident Compensation Act - designed to cover the workplace accidents of employed workers.
This evolved into a universal no-fault public insurance by which all accidents, including those incurred in motor vehicles, and regardless of how injury might have occurred, would be covered.
The principle of lump-sum payments for permanent disability was established along with earnings-related benefits for accident victims during convalescence.
Costs began to rise dramatically, and although attempts were made to constrain these by the National government of the early 1990s, Labour's additions to the scheme since 2002 have seen close to $540 million added to the corporation's liabilities.
The problem is that, like any "benefit", once introduced it comes to be seen as a right rather than a privilege, and fundamental to the issues at the heart of ACC is the distance it appears to have travelled from its original remit.
When diseases such as leptospirosis and brucellosis, and conditions such as asthma, are considered to fall within its purview, the question must be asked "if these, then why not a dozen other conditions?"
Do these not belong within the realm of Vote Health?
Likewise, in attempting to build a degree of risk accountability into the system by escalating steeply the rates to be paid for by, for instance, motorcyclists, the board would appear to be opening a can of worms.
Not that it shouldn't be opened, but if motorcyclists are being asked to pay a premium why not snowboarders, rugby players or others who crowd the emergency departments of our public hospitals in winter as a result of their (self-inflicted) injuries.
And further, why should these people be privileged in having apportioned to them free medical services and costs not readily available to someone who needs an urgent cataract operation, or any of dozens of routine procedures available in the public health system only on a rationed basis?
The question is raised as to what constitutes an accident, and why?
Further, it remains a puzzle that foreign visitors to this country seem routinely to avail themselves of the public health system at little cost, whereas when New Zealanders travel overseas, they must have health insurance.
Such inconsistencies additionally point to the need to reassess the very basis, and the scope, of ACC.
Otago Daily TImes
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