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  • rmacculloch

NZ Health & UK National Health Service are the same model, temples to a dead religion. France knows better.

The UK's National Health System was set up around a decade after New Zealand's one was established in 1938. It largely copied its former colony's. Both are called "single payer" (the government pays the bills) and "single supplier" (most hospitals are government owned). Private health insurance and private hospitals only form a small part of the industry, and are mainly used by the wealthy. Nearly a century later, both the UK & NZ's public health systems are busted; both failing; both sharing the same problems. The US Prime Minister's Health Secretary said last week the NHS 'unquestionably' wastes money and could now go 'bust' without fundamental change. A damning new report by Lord Darzi, a pioneering surgeon and former Labour health minister, concluded the NHS is in a 'critical condition'. He worked, and still does, at Imperial College London, including when I was there in their Health Economics Group. Darzi is the Paul Hamlyn Chair of Surgery and leads Imperial's Institute of Global Health Innovation.


What's the solution to this mess? New Zealand's health-care model is dead. Like the UK's it has become a doomed temple to a dead religion. Parachuting in Lester Levy to fire Chief Financial Officers and blame "back office" managers is slapping a superficial band-aid on the problem. To the extent Levy trumpets he makes some cost-savings and National uses those cuts as 'proof' of waste, it will make the problem worse. It will delay the inevitable, long-term collapse of the NZ "single payer - single supplier" model. What's the answer? Its pretty simple, and different versions exist, but here is an outline. France is a good example - its system is ranked number one in the world in rankings of health-care quality. Everyone who is legally resident there, regardless of income, is covered by statutory health insurance called the Sécu (short for ­Sécurité Sociale). Choice is fundamental in the French ­system, with public & private hospitals competing, both funded by the Sécu and charging the same fees. The competition means the patient is in charge. Not an unaccountable monopoly provider that gets away with treating its customers with indifference. Its a "single payer - multiple provider" model. Even in "socialist" France, quality is ensured by competition between public and private hospitals. Yet unlike America, because France is socialist, it insists on universal health-care, so regardless of income, everyone has choice to go public or private.


Unfortunately New Zealand embraces monopolies. National and Labour don't have the guts to bust our monopoly State health-care providers, our monopoly supermarket chains that threaten teachers with defamation law suits when they dare criticize them, our monopoly building firms, our monopoly gate-way to NZ, Auckland Airport, our monopoly State airline, and monopolies every which way you look. Why? Political commentator Bryce Edwards is right. Lobbyists are blocking change at every step. I've witnessed time and again how the game works in NZ. Its done on an, "I scratch your back, you scratch my back" basis. Favours are done & then repaid, often years later. It's now causing people to perish in our broken health system, a temple to a dead (single payer, single supplier) religion.


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