This week, only a week after they closed relationship Aotearoa, the government announced that they were introducing social bonds to private investors. They are doing so to allow private investors the chance to invest in mental healthcare.
The idea is that people invest in these bonds and only if the results are measurably positive will the investors get their money back!
Mental healthcare patients are among the most vulnerable of patients and here in “man up” New Zealand are also the ones most likely to avoid seeking treatment and if they do often end up between wall and ship because it is so hard to diagnose and treat. It is not for nothing this sector was chosen as the pilot for this new government initiative. Nobody likes a whinger and nobody ever expects to end up needing help for psychological problems.
Make no mistake however. This is a pilot. What that means is, they are testing the water. Expect bonds to be issued for other healthcare “products”. And if you borrow you have to pay it back. The argument that we only have to pay it back if the results are positive is a misleading one because no investor is going to invest in bonds unless there result is a return.
One of the ways in which the private organisations have to prove themselves is by earning money. The only way to earn money is by declaring people fit for work or no longer needing assistance. “Independent” but equally privately owned Assessment organisations do the assessment of people receiving treatment or funding for treatment. These organisations depend on for their work on the results they deliver too. What that means for sick people is that not their health but their ability to go back to work at the most early convenience judged by privately owned company who wants to make money is the most important decision factor. In England one such private assessors is Atos. Atos has been known to judge people lying on their deathbeds fit for work and cutting them off from much needed disability income. Atos forces people undergoing Cancer treatment to go back to work. They have also been known to cut off people with disabilities such as paralysed legs because they were able to push their wheel chairs with their hands.
As someone watching my husband, who had to go back to work way to soon after a serious operation because we didn’t have the funds for him to recover properly, suffer and who is now on ACC (He is one of the lucky ones) because he hit a psychological wall as well as having to deal with the physical consequences of what happened to him, I can assure you that this is not option for long term solutions in healthcare. It will not help people get back to a normal healthy life. It will only make more and more damaged people trying to get on and deteriorating to a point were there are no solutions left. Expect higher rates of suicide, domestic violence, violent deaths and less social cohesion and community.
According to the Ministry of health web page these bonds are currently used or starting to be used in: The United Kingdom, United States, South America, Holland, South Africa, Belgium and Australia, and are being actively explored in Canada, Ireland and Israel.
The purpose for the pilot is (Bold added by me):
- test the concept within the New Zealand context to see whether this is an effective and efficient way for government to reduce social problems
- develop the conditions to use social bonds more widely in the future: including growing the social-investor market and building capabilities of service providers, government agencies and Intermediaries
- learn lessons that could be applied to other forms of payments-for-results and/or outcomes-based contracting
- enable Government to make more informed decisions on whether to use payments-for-results and outcomes based contracting more widely.