Sarah Busby: A second opinion on New Zealand health care
As a person who has lived in the UK (working at Oxford University for 20 years), the USA (Johns Hopkins Hospital and the Salk Institute), and 14 years to date in New Zealand, I take issue with many aspects of Terry McLaughlin’s column on health care in New Zealand.
Firstly, the writer is not comparing apples with apples when using New Zealand as a comparison country to make her point. New Zealand has a population of just over 4 million inhabitants, whereas the USA has 322 million. When you compare them in terms of population density, New Zealand is similar to the state of Colorado.
New Zealand offers completely free medical, surgical, dental and optical care for everybody under the age of 18. Any person with residency in New Zealand and who earns less than $36,000 NZD qualifies for a Community Services card entitling them to free visits to their doctor. The writer in Ms. McLaughlin’s column gives the impression that New Zealanders have to co-pay for all medical services. This is untrue. There is a payment of $30 that residents pay for a GP visit. Further referrals to specialists or to hospitals for surgery attract NO additional charges. She states that taxation in New Zealand is 35 percent, in truth there is a graduated tax scale. At present these are 10.5 percent, 17.5 percent, 30 percent and 33 percent.
Comments about rationed x-rays are misleading. The ‘rationed’ x-rays refer to facilities that are in the private sector. If you need an x-ray, there is no charge at government-funded hospitals.
Waiting lists are always a hot topic. It is true that when a patient has a diagnosis requiring a surgical procedure, they go onto a list. There are target time frames during which the procedure should be carried out. If your regional health-care department has a longer waiting time than the government mandates, you will be offered the chance to be treated in a different region with a shorter waiting time. There are areas around the country which specialize in certain treatments and people are indeed flown to an appropriate hospital for specialized care if necessary. For a country equivalent to Colorado, you would not expect a hospital in Grand Junction to offer the same facilities for specialized treatment as offered in Denver. The patient does not pay for these transport costs.
I have never experienced a shortage of any drug needed by my family. Pharmac (the NZ medical department overseeing drug licensing) does decide which drugs to subsidize. If a drug is still under patent, it is the only brand available and it will be prescribed. Once a drug is off patent and other generic versions are available, Pharmac will fully fund a selection of generic versions and those versions will be the ones available to the patient at a $5 fee per 90-day supply. If the patient still wants the “branded” variety of drug, they must pay full cost. Any prudent person would understand why Pharmac does not want to supply more expensive drugs. Patients are, where appropriate, prescribed a 90-day supply of drugs, after which they must refer back to the GP for further prescriptions. This allows GP to keep a closer eye on the actual health and needs of each patient. If you live further than three miles from the office, you can receive the 90-day supply up front.
It is not true that in an emergency the patient is required to go the hospital in the region where they live. In an emergency, you go to the nearest hospital. Ongoing care may take place in your region, but critical or emergency care is given wherever you need it.
Anybody wishing to enter New Zealand as a resident has to undergo a medical examination and there are certain health criteria that exclude people from being granted a right to stay. The same system applies in the USA, having “grounds of inadmissibility” on health, for applicants who apply for residency.
When referring to doctor shortages, it must be remembered that New Zealand has only two medical schools in the whole country. Suggesting that doctors receive almost instant citizenship in the country is pure anecdote.
Ms. McLaughlin’s column is written with unreliable information from one person’s perspective. I have given a different perspective, while introducing facts. You can find any number of people to promote one side or another of any particular argument. Opinion without supporting facts is a dangerous foundation for building a new health-care system.
Sarah Busby lives in Hastings, New Zealand.
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