[CONTENT NOTE: rape, domestic violence, inhumane treatment of vulnerable people.]
I AM SIDE-EYING THE FUCK OUT OF YOU AUSTRALIA. And yeah, I know that is reeeeeeeeally saying something coming from a citizen of the United States of Avarice, where we will happily privatize for profit everything that isn’t nailed down, and also everything that is nailed down too. Hell, I hesitated even posting about this story, lest I give Paul Ryan et al or
conservative Democrats the Squirrel People any more exquisitely horrible ideas. So please, people: I implore you to keep this information to yourselves during your usual daily barrage of irate calls to your congresscritters.
The headline doesn’t even begin to do this story justice:
Australia’s National Rape Hotline Run By Insurance Company, Who Demands All Sorts Of Private Info
Australia is providing a fairly stunning case study in how not to set up a national hotline for sexual assault, rape, domestic abuse and other such situations. It has a service, called 1800Respect, which lets people call in and be connected to trained counselors from a variety of different call centers around the country. However, as Asher Wolf informs us, a change in how the system will be managed has created quite a shit storm, and [is] leading one of the major providers of counselors to the program to remove itself from the program — meaning that it will likely lose government funding and may go out of business entirely.
The issues here are a bit convoluted [no not really], but since its inception, 1800Respect has actually been run by a private insurance company, Medibank Health Solutions, who partners with organizations who can provide qualified counselors. [MediBANK? Seriously?] One of the big ones is Rape & Domestic Violence Services Australia (RDSVA). While it already seems somewhat troubling that a private insurance company runs the “national” rape and domestic violence hotline – it’s even more troubling when you find out that the company views the service as a profit center:
Earlier this year Medibank healthcare and strategy group executive Andrew Wilson told The Australian that the services offered, which include BeyondBlue, Nurses on Call and After-hours GP as well as 1800 RESPECT, are an active part of their business.
“We have put a stake in the ground and said we’d like to double the operating profit of this part of the business in the next three years.”
And it came to a head a few weeks ago, when RDSVA, whose contract with 1800Respect was up, announced that it was leaving the program entirely, in part because part of the new contract demands from Medibank would have involved having to hand over all of the confidential notes it had on callers.
The new 1800RESPECT contract written by Medibank required Rape & Domestic Violence Services Australia to handover all client file notes resulting from the past six years of counselling for the 1800RESPECT service. We firmly believe that this would breach client confidentiality and contradict Australian privacy legislation.
This requirement causes even greater concern due to Medibank’s position that they will not evoke communications privilege to protect client confidence. Medibank have also provided limited guarantees for the protection of counselling notes if Medibank were to be sold. It is the view of Rape & Domestic Violence Services Australia that this requirement of the contract cannot be met legally or ethically.
[all emphasis in original.]
Oooookay. So, let me see if I have this straight. First, to continue receiving taxpayer dollars paid to Medibank, the nonprofit crisis counseling service providers have to hand over to the company six years worth of confidential communications of rape, sexual assault and domestic violence victims, without even giving the customary lip service to privacy protections. Second, the transparently named MediBANK, is looking to double its profits from this part of its business.
How does this work? Here, I’ve created a helpful infographic of their business model, where the arrows represent the flow of Australian tax dollars:
I suppose one way for Medibank to double its profits from sexual assault and domestic violence would be to significantly reduce the call volume from victims to 1800RESPECT. Reduced demand for services could easily justify Medibank paying less and less to the nonprofits, thus keeping for itself a larger share of the money it receives under its government contract. So let’s just assume for a minute that reduced call volume at 1800RESPECT is in Medibank’s interest. Ideally of course, call volume would plummet because the incidence of rape, sexual assault and domestic violence plummet. That would be a win for everyone (except rapists and abusers), and even I wouldn’t begrudge Medibank making a few bucks by implementing programs that actually reduce the incidence of these horrors.
But there is no evidence of that happening at all. Quite the contrary: Medibank’s new contract offer to RDVSA – whose entire fucking raison d’être is a “Full Stop to sexual assault, domestic and family violence” – would provide significantly less funding than its previous contract did. RDVSA Executive Officer Karen Willis notes that acceptance of Medibank’s new contract “would have resulted in 50 redundancies as the sub contract offer was considerably smaller than the previous sub contract.”
But maybe, just maybe, there is another way to reduce call volume at 1800RESPECT? By oh, say, ensuring rape, sexual assault and domestic violence victims know their calls and records will not be kept confidential?
Alternatively, since Medibank’s current business model is obviously profitable – what would it wish to double if not? – it could be in Medibank’s interest to instead increase call volume rather than reduce it. Then it could justify receiving an even bigger pile of taxpayer cash. Medibank might pay the nonprofits more in absolute dollars than they currently receive (maybe), but that amount would be a smaller percentage of the total. The remainder, of course, is profit.
Let us fervently hope these Medibank motherfuckers don’t go this route, because sooner or later it will occur to some shitweasel that a surefire way to increase calls to 1800RESPECT would be to, you know, increase the incidence of rape, sexual assault and domestic violence, or at a minimum do nothing to discourage it. As a matter of fact the incidence of rape, sexual assault and domestic violence would have to increase by a lot, because Medibank is simultaneously discouraging calls to 1800RESPECT by ensuring that victims know their calls are not confidential.
if you think no one could actually be so evil, hahaha! My dear sweet summer child! Think again. Here in ‘Murikkka, we have an obvious parallel in our for-profit healthcare non-system, where desperate, sick people are driven to bankruptcy for receiving essential medical care, or opt to forego care until a more easily treatable condition becomes catastrophic. But I think an even more analogous and illustrative evil-for-profit scheme lies with private prisons.
[A] growing number of American prisons are now contracted out as for-profit businesses to for-profit companies. The companies are paid by the state, and their profit depends on spending as little as possible on the prisoners and the prisons. It’s hard to imagine any greater disconnect between public good and private profit: the interest of private prisons lies not in the obvious social good of having the minimum necessary number of inmates but in having as many as possible, housed as cheaply as possible. No more chilling document exists in recent American life than the 2005 annual report of the biggest of these firms, the Corrections Corporation of America. Here the company (which spends millions lobbying legislators) is obliged to caution its investors about the risk that somehow, somewhere, someone might turn off the spigot of convicted men:
Our growth is generally dependent upon our ability to obtain new contracts to develop and manage new correctional and detention facilities. . . . The demand for our facilities and services could be adversely affected by the relaxation of enforcement efforts, leniency in conviction and sentencing practices or through the decriminalization of certain activities that are currently proscribed by our criminal laws. For instance, any changes with respect to drugs and controlled substances or illegal immigration could affect the number of persons arrested, convicted, and sentenced, thereby potentially reducing demand for correctional facilities to house them.
Brecht could hardly have imagined such a document: a capitalist enterprise that feeds on the misery of man trying as hard as it can to be sure that nothing is done to decrease that misery.
But that’s just an overview of the concept; it’s the details that get very, very ugly. Let’s look at federal immigration detention, just because of the sheer scale:
Nationwide, more than half of all federal criminal prosecutions last year were for illegal entry or reentry into the United States. More people are sent to federal prison for immigration offenses than for violent crime, weapons, and property offenses combined.
beatings by guards, hundreds of sexual assault allegations, prisoners being denied silverware, maggots in the food, a dangerous lack of medical care…inmates have rioted in reaction to overcrowding, squalid conditions and a lack of anything to occupy their time. Inmates described overflowing toilets, insect-infested facilities and tiny recreation yards that have to be shared by 400 prisoners. The few prison jobs available pay between 11 and 17 [cents] an hour…indiscriminate use of solitary confinement, and extreme cost-cutting measures [have] led to both the death of prisoners and an unusually high number of riots among low-security inmates…”The companies actually make more money by admitting more prisoners from [the Federal Bureau of Prisons] than their facilities were designed to hold,” the report states.
The ACLU study also reported suicides and self-mutilation, and of course deaths resulting from the routine denial of medical care.
Private prison companies insist they do not try to influence immigration law and enforcement, but in 2012 an Associated Press analysis found that the three biggest private prison companies – Corrections Corporation of America, GEO Group and Management & Training Corp – had spent $45m to lobby state and federal governments over the past decade. The three companies brought in almost $4bn in revenue in 2012 alone, according to the ACLU report.
I would be remiss if I did not point out that during the five years of the ACLU study, the Federal Bureau of Prisons overseeing immigration detention was operating under a Democratic President. This is what we justify to ourselves when we vote for the “lesser of two evils.”
Anyway, back to Australia.
However Medibank decides to pursue doubling its profits, it is nonprofits like RDVSA who are actually doing the difficult work to prevent and reduce the incidence of rape, sexual assault and domestic violence. And that is precisely whose funding is being cut by Medibank in the name of profit. If RDVSA were to accept the new contract, they would need to layoff 50 people. As its Executive Officer Karen Willis said:
The decision to withdraw [from the Medibank contract] will also mean about 70 of our highly committed and skilled staff will be made redundant…It is of enormous credit to staff that they overwhelmingly support the decision to withdraw based on ethical, clinical and protection of client file note grounds.
You can read about RDVSA’s work and history here, including its endless need to hit up “trusts, foundations and other philanthropic sources, corporate sponsorship, community fundraising, and through the provision of training and other services on a fee for service basis to raise much needed funds.” If you’re inclined to toss a few bucks their way, you can do that here.
Meanwhile, Medibank – and by extension the Australian government – is manifestly not concerned with adequately funding crisis services for rape, sexual assault and domestic violence victims, or programs that prevent it. Why would they be? There’s no profit in it.
[h/t F. Thalweg]