Monday, 5 March 2012

The older you are the harder you fall ....

I want to register my disgust with a system which requires a hospital social worker to inform an elderly woman who is struggling against the effects of a stroke and severe neuropathic pain, that her last vestige of independence, ie the State pension she paid for all her life through her taxes, is to be reduced to pocket money because she has been in hospital for more than 13 weeks.

Without a family to speak for them, this rule leaves older sick people – especially stroke victims - in a dreadfully vulnerable position.

The possibility of regaining some vestige of their lost independence and dignity is often all that keeps them going. To have the financial means of achieving that independence ripped away from them, to add to the already enormous burden of stress and anxiety they are experiencing, is nothing short of cruel – not to mention, counterproductive.

The cost of keeping a stroke victim in hospital is far greater than the amount the state claws back from the meagre State pension – as indeed the costs of long-term nursing care will be if they are unable to regain their independence.

It is in everyone's interests to get them back to being fully or partly independent as quickly as possible and the people involved in geriatric stroke rehabilitation work hard to see patients regain sufficient mobility etc to be able to return home.

Having a home waiting them is therefore a vital part of rehabilitation and obviously there are essential ongoing expenses involved in that. Yet, the system reaches a cut off point and requires fragile, disabled people to make the case to have part of their pension reinstated to keep up those essential payments – rates, insurance, gardening, care of pets etc.

But they have to know they can do this, have the will to do it and be able to do it.

Many may have lost the ability to write, they may have lost language function and, most critically, they may be confused and easily stressed by anything complicated or unusual.

The system doesn't establish if there are essential expenses before clawing back what's left – it grabs it all except $33.50 a week and places the onus on the individual to make the case to get some reinstated to meet those expenses.

But – what I have an issue with is the workhouse-style mentality behind the rule.

Like many rules thought up by well paid bureaucrats looking forward to a fat occupational pension, and rubber stamped by politicians of similar mindset and circumstances, it affects poor people worst.

A person with an occupational pension or income from other sources cannot have that touched by the State when hospitalised for more than 13 weeks. It is only any element of income administered by the State that is clawed back – primarily - because it can be. 

And that's the nub of it.

NZ superannuation may be based on investments; the administrators of the scheme may have fancy job titles and be paid a lot of money; it may call its scheme members clients; the state may treat them as tax payers (even to the point of still taxing their pocket money!)– but the mindset of those who framed the legislation was firmly locked in 19th century notions of State administered charity.

The 13 week rule undermines the principle that the old age pension is an inalienable right, ie society acknowledging the financial contribution older people have made through their work and taxes.  

It also highlights the fact that NZ Superannuation is not a normal superannuation scheme that happens to be administered by the State. It is still a benefit which the State retains the right to claw back to offset long term health care costs.

After 13 weeks of hospitalisation, the State superannuant has to pay, in part, for the free hospital care everyone else enjoys.

I can see the logic when a person goes into permanent elder care of some sort although even then, the reduction of State pensioners to recipients of pocket money ie $35 a week  and a $250 a year clothing grant -  has a Dickensian feel to it.

All beneficiaries, including unemployed people, are affected by this rule and there are arguments to be made about that, but my concern here is with pensioners.

It may be convenient to have a 'one rule fits all' approach but this cold, bureaucratic calculation sends a potent negative message to already vulnerable people.

That message is they are unlikely to ever return to home and their home will be sold to defray their long-term care expenses.

This may galvanise some into greater efforts to recover and get their full pension reinstated but the reality is that for others it will knock out what little stuffing they have left.

It has the very real potential to add huge stress to already anxious and frightened people and is likely to undermine the mental and emotional strength they need to fight against the combined odds of age and serious disability.

The fact that families will often find the means to pay those domestic expenses is not the point.

The point is that this treatment of State pensioners constitutes a breach of their human rights - if not in terms of the current law – then certainly in terms of natural justice.

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