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Opinion: Why competition for ACC is not necessarily a bad thing

November 10th, 2009

By Infometrics economist Chris Worthington

It was only a matter of time before the mounting losses at the Accident Compensation Corporation lead to ideologically-charged plans for opening up the work account to competition.

Opposition parties equate competition with privatisation, or the equally dirty “P” word, profits. Private insurance companies will be, heaven forbid, making money out of providing insurance.

Never mind that this implies some logical contortionist act where private profits are worse than public losses. Never mind that it doesn’t make sense to believe that private insurers will be able to win lots of business off ACC despite supposedly charging more (as their “profit motive” dictates).

It is helpful to separate the imaginary risk from private competition from the real one. It is an illusion that we’re better off when the government provides a public good for “free” rather than when a market provider offers it for profit.

The true cost to society is still always the opportunity cost of resources being employed to provide the good. The people and capital involved with ACC could be put to use in alternative profit-making industries. Or to put it another way, ACC is already equivalent to a profit-making insurer that pays out all its dividends to its owners (the taxpayer) in terms of product rather than money. This wouldn’t be an attractive notion for shareholders in, say, McDonald’s.

There is an added inefficiency in the above process. The price the end users see for the service is lower than the true cost of the service (which included earning normal rent on the assets employed). We can expect, therefore, that we get more of this service than we would in a free market. In this case, ironically, we are making accidents cheaper than they “should” be, and consequently encouraging more of them through less individual responsibility. For this reason alone, it would be preferable if ACC was run as a for-profit institution.

But there is a genuine problem to allowing private competition for ACC, arising from the unfairly tilted playing field for the state provider. ACC effectively operates with a dual mandate of an insurance scheme and a welfare scheme, with a lot of cross-subsidisation between the profitable areas and the money-losing ones.

In these circumstances, if the competition is allowed to charge actuarially fair prices to ACC’s profitable customers, they can easily undercut ACC. This kind of cherry-picking would make ACC’s model unsustainable without massive price hikes or direct subsidies from general taxation.

That outcome is not necessarily a tragedy. A good economic rule of thumb is that people are normally made better off by giving them cash and letting them face true market prices, rather than simply giving them subsidised goods. And making the welfare component of ACC more explicit and transparent would make it easier for us to weight the value versus other social interventions.

After all, we want there to be clear signals that certain activities and jobs carry (expensive) risks, in order to discourage people from pursuing them, without making reasonable attempts to reduce the associated risks.

Realistically, though, it is more likely that the government will instead opt for some way of levelling the playing field. There are two obvious ways: either demand that private insurers cover a similar cross-section of employer types as ACC, or demand that private insurers reimburse ACC for the welfare component of the levies that would have been paid to ACC by their former customers.

If private providers are still keen to play on those terms, we can be more confident that there are needless inefficiencies that can be wrung from the ACC structure, or benefits from employers having more choice as to their level of cover. Neither of these things are bad, even if they do result in profits for the insurance industry.

But competition can go both ways. There is something quite appealing about the government and the private sector going head-to-head in what we might term the “KiwiBank” model, where the government directly competes with the private sector in an attempt to limit pricing power. It is one thing to make the easy claim that government institutions are inefficient dinosaurs, or that private companies are rapacious profiteers. It is another to test this model by allowing competition between the two as a relatively low-cost solution.

This style of government intervention is not pure economics (normally interventions require evidence of market failure), and it is easy to see government franchises extending into all areas of the economy based on optimistic empire building. At the same time, it is silly to deny SOEs the opportunity to expand where there is a business model that compliments its core operations (as banking did for NZ Post).

We shouldn’t be afraid of competition in economic strategies being fought out in the marketplace. The success and failures will be valuable for future policy decisions, provided we take on board one ruthless lesson from free markets – when ventures fail, you have to be prepared to cut your losses.

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* Infometrics is an economic information and forecasting company based in Wellington. To find out more, see its website here. This piece first appeared in the Dominion Post.

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8 Responses to “Opinion: Why competition for ACC is not necessarily a bad thing”

  1. steven Says:

    The issue I have with competition in this situation is cherry picking and Pollies….in the USA health insurance companies only want healthy people and go out of their way to not payout. Here it could be similar, there could be nothing stopping private companies cherry picking low risk/cost areas and declining high cost/risk areas, leaving those high risk/cost to ACC….The second is time limitation….private companies seem to limit payouts to say 6months or 2 years, after that you have nothing….(does ACC?) .

    The same happens with healthcare for operations to drop waiting lists …a hip transplant is a known cost and can be accurately assessed so is ideal for a private entity to price on, an unknown illness isnt so is not delt with its left to the public healthcare system to pick up the expense…

    So while we should be able to compare Im concerned that ACC will appear to be more expensive because its left with all the problem cases so its costs would rocket because it actually has to pay out on less income while the private company(s) isnt…

    Then the (National) Pollies step in and say that ACC is obviously poorly run and lets dump ACC…

    So the biggest thing is to ensure a level playing field and not one biased to suit the pre-conceived ideological outcome the Govn of the day wants.

    and of course Pollies wouldnt do that would they?

    ;]

    regards

  2. Chris Says:

    Cherry picking is a huge issue for me as well.

    However I can see myself getting more annoyed at the foreign insurers that will turn up, sending their profits back to Australia and Hong Kong.

    Winston would have a thing or two to say about this…

  3. Steptoe (Steps) Says:

    A well balanced article..
    “In these circumstances, if the competition is allowed to charge actuarially fair prices to ACC’s profitable customers, they can easily undercut ACC. This kind of cherry-picking would make ACC’s model unsustainable without massive price hikes or direct subsidies from general taxation.”

    This piont is something often overlooked or ignored by those who argue the P word… regarles of where the P word is appiled…ACCpoint prison , hospitals….
    Too often when Privatisation has been applied in the past, the augment in retrospect has been “well since Privatisation competition started the Gov operation runs at greater loss, therefore it follows the private sector is better”

    Again illustrates where Bean Counters study stats and have very little understanding of what is behind them or can apply basic common sence…Draft horse with blinkers on

  4. 28_yr_old Says:

    I work in the health industry

    Privitisation in 1998-1999 was a flop, big delays and increased costs for patients

    If ACC is privitised then insurance companies need to provide the sames services as ACC

    Currently private insurers can take 6 months to pay for invoices for health services

    The aussie insuraance companies will rape the profitable workers account and leave the non profitable non-earners account

    If ACC is privitised I am told by a Treasury representative that insurance companies will have to play by the same rules as ACC. I will take patients time to cotten on that they can ask for a “review” of a claim decision costing $3000-5000 followed by lengthy in-court battles. In the end the lawyers will win and that $15000 hip replacement would of seemed a lot cheaper!

    Leave it as it is

  5. Allen Says:

    Here goes ACC. What’s next, Kiwibank?

  6. Emkay Says:

    What is the guarantee that the private insurers who might get a share of ACC business will not go the way AIG has done in USA (that is invest unwisely) and go bankrupt or out of business, dumping the mess back in the Government laps ?

  7. Terry Says:

    What everyone is saying is let’s leave a proven inefficient system in place and be happy to pay the price. If ACC under Government control is such a good model why doesn’t Goverment get into all types of insurance?
    I think a good model is to introdue competition but maintain a Government presence in the market under a competitive model to ensure an even playing field. That way we get the innovation and delivery of the private market matched with the control of a Government player. IE the banking model.
    There’s no doubt that inefficiencies have crept into the ACC system following the renationalisation in 1999. It’s time to put a system in place that self polices this.

  8. KW John Says:

    Allen.
    or Genesis?

    http://www.odt.co.nz/news/business/85808/suggestion-genesis-could-hold-meridian-energy-ransom

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