45 The Battle to Make the Health Insurers Obey the Law – Part 6: 10 October 2024
It should have been no surprise to HCF that I outright
rejected the completely offensive “resolution” it offered in its 21 January
2022 email. The email had one definite
effect on me – it significantly increased my annoyance with HCF.
My response to the HCF proposal was a five page
letter which I sent by email on Monday 24 January. On page four of my 24 January 2022 letter, I left no room for doubt about what I thought of HCF.
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HCF has
acted unlawfully towards my wife and towards all other cancer patients who
have received treatment from Lift. HCF
proposes to continue to act unlawfully towards my wife and towards all other
cancer patients who have received cancer treatment from Lift in the past and
who may receive cancer treatment in the future. HCF has not proposed any “resolution” at
all. It has proposed throwing a few
dollars in my direction so it can continue to act unlawfully into the
indefinite future. If HCF
wishes to resolve my complaints, it must deal with the fundamental
issue. The fundamental issue is that
medical treatments are proposed for patients by medical practitioners and not
by health insurers – and hospitals are “accredited”
by appropriate government agencies and not by health insurers. Any approach by HCF which ignores the need
for HCF to comply with the law is unacceptable. |
Although I did not yet have evidence of what HCF was doing, my statement that “hospitals are “accredited” by appropriate government agencies and not by health insurers” went to the very centre of what was going on in relation to the Lift Cancer Care insurance claims.
HCF was
indeed ignoring the hospital accreditation process implemented by the
government to protect the health of Australians. HCF had implemented its own hospital process which ignored the health of Australians and focused
solely on how much money it could make and on the control it could exert over
the health services provided to Australians.
****
My attitude was very clear and easy to understand.
If the law did NOT require HCF to pay for the
claims, I wanted to know the precise legal reasons why the claims were not
payable. If HCF had been able to identify a legal basis for its conduct, that would have been the end of
the matter. I said this on
page four of the 24 January letter.
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I
recommend that HCF immediately stop acting unlawfully and immorally. Action which is lawful and moral will bring
an immediate end to my complaints and to the other complaints that are likely
to be lodged in the near future. My
sincere hope is that HCF will stop acting like an American “managed care”
insurance company and start acting like an Australian health insurance
company that obeys the law and which displays a genuine conscience. |
****
Sir Humphrey Appleby was a central character in
the British comedy series Yes Minister. For those who
are too young to remember Yes Minister, this is what wiki says about it.
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Yes Minister is a
British political satire sitcom written by Antony Jay and Jonathan Lynn.
Comprising three seven-episode series, it was first transmitted on BBC2 from
1980 to 1984. A sequel, Yes, Prime Minister, ran for 16 episodes from 1986 to
1988. All but one of the episodes lasted half an hour, and almost all ended
with a variation of the title of the series spoken as the answer to a
question posed by Minister (later, Prime Minister) Jim Hacker. Several
episodes were adapted for BBC Radio; the series also spawned a 2010 stage
play that led to a new television series on Gold in 2013. Set principally in the
private office of a British cabinet minister in the fictional Department of
Administrative Affairs in Whitehall, Yes Minister follows the ministerial
career of Jim Hacker, played by Paul Eddington. His various struggles to
formulate and enact policy or effect departmental changes are opposed by the
British Civil Service, in particular his Permanent Secretary, Sir Humphrey
Appleby, played by Nigel Hawthorne. His Principal Private Secretary Bernard
Woolley, played by Derek Fowlds, is usually caught between the two. The
sequel, Yes, Prime Minister, continued with the same cast and followed Hacker
after his unexpected elevation to prime ministerial office. |
Wiki says this about Sir Humphrey.
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Sir Humphrey is a master
of obfuscation and manipulation, baffling his opponents with
long-winded technical jargon and circumlocutions, strategically
appointing allies to supposedly impartial boards, and setting up
interdepartmental committees to smother his minister's proposals in red
tape. |
In case anyone thinks otherwise, when I awarded the
“Gold Medal” to Junita Lindsay, I was being sarcastic.
****
This is a copy of Junita’s “Gold Medal
Certificate”. I remain rather proud that
despite the circumstances, I produced this “Gold Medal Certificate” for Junita Naturally, I am disappointed that she never thanked
me for her Award.
SIR HUMPHREY APPLEBY “YES MINISTER” FOUNDATION*
By this Document and Certificate
Be it Known to All and Everyone Without the Need for Any Further Proof
that the following Award has been Presented on the Dates set out Herein to the
Below Named Person
GOLD MEDAL
WINNER OF
AWARD: Junita
Lindsay
Dates of Award:
18 January 2022
- AND –
21 JANUARY 2022
REASONS FOR
AWARD: OUTSTANDING USAGE OF MEANINGLESS WORDS
* Consumer Advisory Notice: The Sir Humphrey Appleby
“Yes Minister” Foundation does not really exist.
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