by Kevin Hague
As reported in the Herald today, Auckland DHB is worried that it could have $150 million dollars slashed from its budget. This is the natural result of National’s plan to progressively cut the national health budget in coming years without investing in public health initiatives that would help drive down long term health costs.
This is a sign of things to come for all DHBs. We know health costs are rising and health cuts are coming. If the Government continues to refuse to invest in reducing costs this will inevitably lead to a cut in the health services that New Zealanders have a right to receive.
We know that many DHBs are already struggling to maintain health services with their current budgets and any cuts raise the spectre of decreased quality of care and patient safety being compromised. Of course there is room for improvement in how the health system operates but slashing the budget moves us in the wrong direction.
What really worries me is that National’s long term plan for meeting rising health costs seems to be the tacit encouragement of private insurance and shrinking state cover. We have already seen this in the contracting out of surgery to the private sector which undermines public hospitals and ignores underused hospital theatres in the public sector.
The problem with a private insurance model for the health system is that it is unfair – it will mean a two tiered system where the rich get better health care than the average kiwi. The Green Party believes this is wrong as all New Zealanders should get the health care they need and the quality of this care should not depend on how much money they have.
It is becoming clearer and clearer that National is quietly advancing its privatisation agenda in health and ACC – they know how unpopular this agenda is with the New Zealand public so it’s being done by stealth and spin. This can be seen in their undermining of our public health system and the manufacturing of a crisis with ACC.
The only question left (as the bikers at the ACC rally so poignantly put it) is who’s next?
Published in Environment & Resource Management | Featured by Kevin Hague on Thu, November 19th, 2009
Tags: DHB, health cuts, Kevin Hague, privitisation
More posts by Kevin Hague | more about Kevin Hague
on the trolls and those who are unable to keep on topic
Perhaps National is next. All we have to do is remind everyone of who is actually responsible…
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Then there is the other side of the arguement when you have part public / part private health (or education) systems.
And that is that the rich pay twice, effectively paying at least their share (or more than their share) of the public sector, even if they don’t use it PLUS again for their private healthcare / education.
It’s a good way of effectively making massive tax rises for the rich, without them realising it (AND public sector savings).
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I think that alternative health therapies including herbs & vitamins should be allocated the same funding or subsidies that are presently available to GP’s & pharmaceuticals!
& as they’re not designed to cure whatever a person’s ailment is or are pharmaceuticals should be eliminated in their entirety from the health system! (THEY’RE ONE HUGE SCAM!) There are healthier alternatives such as:
1. those already mentioned (i.e): herbs, vitamins & althernative therapies.
2. removing all chlorine & fluoride from all public water supplies including public swimming pools! Using Ozonating systems in replacement of these toxic substances!
3. that it be mandatory for all producers of food & consumable liquids converting to organics & go thru a certification process!
Thus eliminating all unhealthy preservatives, all unhealthy additives & all insecticides or agricultural sprays from all food & all consumable liquids!
This resonates with the wisdom of Hippocrates when he said: “let food be your medicine & let your medicine be your food!”
4. any kind of GMO product be prohibited from entering NZ or been created in NZ.
If any govt were to implement all the above, that would hugely reduce it’s public health bill!
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Most alternative remedies are placebo. They are not backed by science.
http://www.skepdic.com/tialtmed.html
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Hidden due to low comment rating. Click here to see.
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Works a treat in the US, eh bro?
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Tell Rodney the Percolator to wake up and smell the coffee.
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Private health insurance is a horrible idea that has been shown to be horrible over many many years in the US. There are many reasons why it doesn’t actually work to provide anything like equal access to basic medical care, and one suspects that this is not something you care about anyway.
We do.
As for alternatives, I would settle for allowing me to buy anything proven not to be harmful… and it is up to me to work it out for myself.
respectfully
BJ
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Private health insurance is a horrible idea that has been shown to be horrible over many many years in the US.
Perhaps i’m missing something (seriously), but if it’s so horrible, why do over a million NZers have private health insurance of some kind>?
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And why do 47 million Americans have no health insurance and millions more have inadequate health insurance.
And why is the US the only industrialised nation that does not have a universal health care scheme? You would think if it were such a great idea, others would have followed.
I think BJ was talking about a fully insurance-based health system with no public component.
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And why is the US the only industrialised nation that does not have a universal health care scheme? You would think if it were such a great idea, others would have followed.
I don’t think anyone arguing for more private sector involvement in some way is advocating the US’s heavily regulated-but-also-kinda-private crazy system – this is often a ‘strawman’ argument of opponents of private sector involvment (not saying you’re doing it). There are a few health sector models in the world which sound like they work very well (off the top – singapore, france, switzerland). Would be good if a party/parties declared they were aiming for something in particular, rather than warm fuzzies like ‘equitable healthcare but leave the details to us’.
I think BJ was talking about a fully insurance-based health system with no public component.
Hence my ‘missing something’. Ok.
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It works well for the people who have it Toad.
The Yanks (rightly so) are up in arms about being forced to pay for their own insurance and for the insurance of others.
Ever wonder why the USA has the some of the very best doctors in the world Toad?
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Sorry StephenR…
You may not know it but most everyone here does and I made an assumption. I AM one of those annoying refugees who actually use all the vowels and sometimes ‘y’… and who recognizes that HMO is actually a euphemism for assisted suicide in the USA.
Which is to say… I am speaking from MY experience which is bitter and long, and the comparison with what is in place here is quite amazing. Something that gives us a laugh sometimes… like the American MD I ran into in Wellington who asked (when I was commenting on an aspect of community support offered here) me to imagine the same support back in LA…. We both broke down laughing, uncontrollably, for at least a full minute.
Which is to say that a combined system, which is a model that exists in some of the other countries in the OECD, is something I do accept might work OK… note the use of the word “basic” in my original response if you will.
The fact that I would not at this point, owing to their record over the past year, trust National or ACT within ten kilometers of the family tin, much less the silver, militates against my accepting any of their notions at face value.
I expect the worst from them, and so far they have not disappointed in any respect.
respectfully
BJ
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What’s more, people don’t collect wealth in isolation; most wealthy people collect their wealth not by working harder, but through a series of unequal transfers, where hard-workers get paid very little, and the wealthy reap the benefits. But for this to work, the wealthy rely on the public system to provide education and health services to those off whose back they get wealthy.
The average user of privitised healthcare and education gains more from public systems than anyone else, so it is entirely fair that they should have to contribute to funding it.
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I suspect that if you honestly research it you will find that it is not… but I am not going to put you on the spot about that. All you need is an opinion about it for the moment.
We believe that too much inequality is BAD for society and bad for the country.
That is a core Green position. I hold it to be true. Period.
Do you want to play dueling research about it?
Do you accept it? (follow on question – Do you want to discuss how much is too much?)
Should we agree to disagree?
respectfully
BJ
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Hidden due to low comment rating. Click here to see.
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(1) there are 300 million people in the US, so there’s a lot of talent to choose from
(2) The US has some very good universities, which are capable of training people to be very good doctors
(3) The US is a sufficiently wealthy country that those well-trained doctors are unlikely to belured away by better pay elsewhere
The United States with a public health system would still have some of the best doctors in the world.
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Big Bro wrote: “It [the US health system] works well for the people who have it Toad.”
So it’s good so long as you don’t (1) have a pre-existing medical condition that stops you getting coverage? or (2) lose your health insurance becasue it was a perk of your job and you lost your job?
Actually, that’s not quite true – it’s also very inefficient. Despite all the uninsured people getting a lower standard of care, the US health system still costs the country 16% of GDP, versus only 9% of GDP in New Zealand.
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the US health system still costs the country 16% of GDP, versus only 9% of GDP in New Zealand.
Oh for some tort reform.
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I don’t think that too much inequality is bad for society. I think it is good because it engenders respect for the wide variation nature encompasses.
The real problem with inequality is when selfishness creeps into the equation. For example – when a rich person builds their personal wharf over a stretch of beach they don’t own, thereby preventing others from accessing that resource.
As long as one persons wealth isn’t used to increase another persons poverty I have no problem with the wealth.
(I’m rather communist about land – it’s a finite resource that should not be locked up as a means of wealth accrual because that removes the opportunities for others to access land in order to live within their means.)
In terms of the health system – I think it has become very obvious that we cannot afford to aim for the level of easy access we previously had.
If $150 million is going to be shaved off the budget then I would prefer to see obese people locked out from publicly funded care, rather than mentally ill people locked out from adequate care and/or housing.
I see mental health issues as generally being less “self-controllable” and less “self-healable” than obesity related issues.
We have no choice but to prioritise where we will spend the finite $ we have.
It is not a question about whether or not there should be limits – it is about what we trim, and from where.
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What? On what evidence can you base that (apart from your own philosophical musings…).
It is not that we must have a society where all are “equal” meaning the same, but where some cannot afford shoes while others go for January skiing holidays in Switzerland I think we can say there is too much inequality.
It is not a sin to be rich. It is a sin to be poor. It is the sin of the rich.
peace
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StephenR
Can’t have that! Gawd… half the folks elected to office are – Lawyers.
People “skilled in circumventing the law”
Trained to ignore facts and argue what they are paid to argue.
———–
I used to argue for this reason (when I was younger and more idealistic) that the US needed an amendment clarifying the separation of powers, one which made lawyers eligible to serve ONLY in elective positions in the Judiciary or the Executive, and never in the Legislative branches except as advisors to legislators.
Recognizing that this will happen when hell is a hockey rink, I have since moved on.
respectfully
BJ
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Heh nice ‘try’ anyway.
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StephenR said:
“Oh for some tort reform”.
You mean like ACC, where doctors only face sanctions if they are actually below par, rather than being forced to get insurance so they can pay compensation when the calculated risks all doctors have to take turns into a medical misadventure?
Let’s hope National get voted out in the next election before they can completely gut ACC.
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BJ:
“As for alternatives, I would settle for allowing me to buy anything proven not to be harmful…”
Ok, but that lets out asprin, paracetamol, all common vaccines, and anything that’s been through a normal phase-4 (release to the public and discover the rare side-effects) clinical trial; and that’s without engaging with philosophical issues of the and-you-can’t-prove-a-negative kind.
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Its not always the sin of the rich.
If that is true you would “even out” wealth by selling off everything you own and sending the money to Africans.
Or maybe you have some justification for having more possessions than Africans??
What you really need to ask is this: “Is Blisses wealth keeping Africans poor?”.
Only you can answer that, but I’m guessing your own wealth has nothing to do with the poverty of Africa.
Or even the poverty of any New Zealander who happens to have less than yourself.
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NZer’s should have the right to choose whether their ailments be attended to by a GOVT SUBSIDISED GP & pharmaceuticals or by a GOVT SUBSIDISED alternative therapist & vitamins/herbs!
& NOT THE FORMER ONLY!!!
The PHARMACEUTICAL COMPANIES & those that they have in their back pockets are laughing all the way to the bank!!!
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Only $150m?
That is only three days worth of borrowing from our children to pay for the health care of us today.
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Greengeek wrote: “If $150 million is going to be shaved off the budget then I would prefer to see obese people locked out from publicly funded care, rather than mentally ill people locked out from adequate care and/or housing.”
what about people who are obese due to side-effects of anti-psychotic medications?
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FreeAdverts,
Rather, it should be government subsidised medications that have been shown to be highly efficacious rather than any particular subtype. If it is from a pharmaceutical company or from a plant is besides the point.
Pharmaceutical companies make large profits but those profits are justified by the massive investments required and the massive gambles they take everytie they attempt to develop a drug. Just because they dont give it out freely hardly makes them forces of darkness. Pharmaceuticals are often very effective.
Natural treatments can be very effective too. The difference is that natural treatments do so by coincidence while pharmaceuticals are targeted specifically to have effect. Both should be subject to exactly the same legislation and both should only be allowed to claim that which has been shown. Both should be subsidised if they are proven efficacious.
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A painful question for me, as I have a family member with exactly that problem.
But this is a good example of exactly what I meant when I was saying that mental health patients need more money spent on them. The weight gain is one of the prices they pay for the illness they suffer, which (as far as I can tell) is a result of nothing they have done intentionally.
By contrast, most other obese patients (although not all) can make a decision to eat less, and thereby improve their health and reduce medical costs.
My point being of course – that we should focus our health spending on those who suffer illness and/or accident that they have no means to avoid.
When the amount of money available to treat people decreases, we have to spend less, and at such times it becomes more important to prioritise spending.
At the risk of sounding harsh, I would rather we spent more on health, less on education, and nothing on refugees.
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StephenR wrote “Perhaps i’m missing something (seriously), but if it’s so horrible, why do over a million NZers have private health insurance of some kind>?”
What you are missing is that health insurance here and health insurance in the USA are two different beasts.
Health insurance here is something you get if you want a little extra safety net above the public system: it means you will get more prompt treatment (avoid the waiting lists), and may be a bit more comfortable. It also covers some of the cracks in the public system, for people who are not quite ill enough to get into the public system, or people who would have a poorer prognosis if treatment is delayed. In general though, if you get ill, the public system will suffice (although it has gone downhill in that regard the last while). Ideally (better public system), insurance here should be unnecessary, but in practice it does have some value. The rise of insurance here can be seen as a not very good sign of issues with the public system.
In the States, it is the only way (unless you are old, extremely poor or very rich) of getting heath care. If you don’t have it and get sick, you are expected to pay for it yourself, and can be in real trouble. Also, because of it’s more central role, it costs a _lot_ more. The insurance companies don’t just get a cut of the cream – they get a cut of the whole pie, and your treatment is approved (or not) by organizations that have a primary goal of making money.
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StephenR wrote “Perhaps i’m missing something (seriously), but if it’s so horrible, why do over a million NZers have private health insurance of some kind>?”
It’s not the fact of personally having health insurance that’s a bad thing. The bad thing is the existence of a system (in the US) in which you’re stuffed if you can’t get health insurance.
I don’t think that’s the case in New Zealand, and I hope it’s not, because I don’t have health insurance and can’t get it.
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Yeah thanks, you two and BJ have cleared that up for me – what i suspected anyway. Wonder if/when National will attempt to give tax breaks for those with private insurance…
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Just to add a personal note to that (am I allowed to do that in a blog comment?), I’m about to go to the USA for work, and one of the big question marks for me is whether a 40+ year old with asthma and interesting family medical history, who has never had health insurance before, will be able to get insured, and how big a bite is it going to take out of my income? I’m shifting from a country that used to have one of the best health systems in the western world, to the country with one of the worst.
If that falls over, then my stay in the USA won’t be for very long, and will help me appreciate what we have here.
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Roy, wouldn’t that have been a good question to ask your employer before accepting the job?
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StephenR: I did talk with my employer – he thinks getting health insurance won’t be a problem, but the company doesn’t itself have a health plan for employees. He also knows (I’ve told him) that if I can’t get insurance, or find any other real show-stopper over there, then I’m flying back to New Zealand (and they are paying).
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Ah. Quite unusual for a company not to have a health plan(!) I understand. Good on you for all that though.
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Thanks for that. It is an odd situation, especially for an IT company. The company is very small (I’ve been consulting for them for a few years), but it’s got people in more than one state, which apparently makes providing a health plan difficult for them.
The risks of me going over seem to be at their end – it’s not a huge problem for me if things don’t work out – I can just come back here (and keep consulting). I am aware though that there are lots of ways we do things better here than there (like the health system) that I’m going to have to adapt to. I’m sure there’s things that they do better too – I can’t think of any offhand though, except that the city I’m going to actually has a good public transport system (I’m planning on not having a car over there).
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Hmph. I’d start sorting out who you’re going to go with NOW, there’s an awful lot choice and you wouldnt even want to spend one day uninsured over there.
Not many people point to the US as the best example of anything, yeah, though it’s so diverse in the sense that states seem to have so much power it’s almost not worth generalising about the US, i’ve found. An enjoyable place though, would certainly like to live in a few cities that i’ve been to – possibly need a bit more moolah though.
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Well, I’ve currently got tickets for a month, accommodation arranged for that time, and travel insurance (including unlimited medical). I certainly wouldn’t want to spend one day uninsured over there either.
Offtopic for this thread I know, but the city I’m going to is Eugene, Oregon. I’ve visited there a few times, and it seems nearly as good to live in as Dunedin. It also seems to be one of the more enlightened states in some respects. There’s a difference between visiting and living there though. I also plan to stay for a maximum of three years.
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