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New Zealand to consolidate healthcare into national service similar to Britain's

41 Comments
By NICK PERRY

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41 Comments
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Do you want Medicare for all in the USA? I do

0 ( +0 / -0 )

From what little I know of the US system

I do. I know a lot about it. I know a number of people who have been burned financially even with insurance and this includes my own family members. You get free choice if you are a rich. But I also heard that rich Americans sometimes go to UK private hospitals for something not yet available in the USA (but is available to people UK hospitals). A couple of cases in Japan for a certain kind of stomach cancer treatment (yes, they take cash here)

0 ( +0 / -0 )

If there is a mandate, then the Singapore way is better in that individuals have control over how their share of the money is spent on themselves.

Places like the UK, New Zealand, Singapore have already got this, so that would be the right way to reform for such places.

The US system is it’s own thing as you say and if people are free to choose entirely, well that’s interesting but different situation politically. Still, the element of personal choice is an important one. From what little I know of the US system it sounds like people don’t really have free choice as they are constrained to go to who their insurer says. That’s not exactly my idea of free enterprise competition :)

Interestingly I saw this pop up today out of New Zealand - a reform proposal for mandatory but individual savings accounts:

https://www.downtoearth.kiwi/post/what-a-real-health-care-reform-looks-like

Japan with its blown out budget will surely head in this direction one day, I believe.

0 ( +0 / -0 )

Healthcare in Singapore or the Singapore healthcare system is supervised by the Ministry of Health of the Singapore Government. It largely consists of a government-run publicly funded universal healthcare system

(Wikipedia)

There I checked Google, yes I want it since it's "universal" but there are too many non-intellligent Trump people to make it come to fruition

0 ( +0 / -0 )

Although I want a mandate too many Trump voters don't so Singapore or any other universal type system is not politically possible. Singapore is still universal type - it is not possible in the US due to politics. Americans (Trump type specifically) just talk about the British or Canadian system (in a bad way). Almost no Americans know anything about the Singapore system other than they have a mandate for cost control. But I heard good things about the Taiwanese system...in fact when they were designing it they wanted to stay away from how the US does it. Again Trump people see mandates as an evil tax.

0 ( +0 / -0 )

What Americans want the Singapore type system because I have never met any? 

You elected to not Google it I see

0 ( +0 / -0 )

I'm torn.

I like the "idea" of nationalized health care, preventative care and advice, but I worry that new drug development will end if the world removes the profit incentive.

When will Japan be getting vaccinated?

The US will be done, probably by July. If someone in the US wants elective surgery for something, they can get it done, probably in a few days. Yes it is expensive and I'd happily trade universal service over a 1 week delay in service and seeing 50% of doctors living in mansions.

The pharmaceutical reps all drive extremely nice cars in the US. We know where all that money comes - from therapy and add-on health care pricing.

Overall, national health care is probably better than other alternatives, provided the country negotiates hard on prices ... cough ... unlike other govts.

There are definitely many things to like about NZ. I looked at "migrating" there previously.

0 ( +0 / -0 )

Is this the same govt of NZ cosying up to the CCP at the expense of the 5 eyes we read on other news sites today ?

-1 ( +1 / -2 )

Japan should do the same.

It sure as hell shouldn't. I don't want waiting times like I had with the NHS. The Japanese system is good as it is (if only the doctors were better trained).

2 ( +2 / -0 )

 The Americans (and others of course) appear very interested in the Singapore model

I probably would because it has a mandate which help control costs for middle class especially. But too many Americans see mandates like Obamacare as a tax. Conservatives, especially the Trump kind would give it a big NO because they would see it as against their freedoms. I'm American and I know almost nothing about the Singapore system other than it's like universal after a quick wiki check . And I don't know any American (for or against Obamacare) who have any thoughts or knowledge about the Singapore system. What Americans want the Singapore type system because I have never met any? But I know some Australians and from what I hear I think I would like that system for the USA since it does a good job covering catastrophic claims (which the USA is terrible unless you are either rich or very poor).

-1 ( +0 / -1 )

If seriously interested, try googling it. The Americans (and others of course) appear very interested in the Singapore model, and they don’t seem to think it’s the same as what they have at all.

-1 ( +0 / -1 )

Sounds like the American system. Takes care of the poor with Medicaid, but burns the middle class even though they have "free choice" including common pharmaceuticals that are illegal in Japan like Vicodin.

0 ( +1 / -1 )

I don’t have a problem paying for the poor either.

The problem is that it’s not the poor who get to control the money, it’s bureaucrats and special interests that get to.

We should absolutely be funding the poor, and the Singapore model offers a demonstrably better approach than wholly centralized approaches elsewhere, if judged by actual outcomes (which should be the important criteria, not ideology)

-1 ( +3 / -4 )

No it means the middle class does not get burned like in the US. I'm middle class in Japan and I don't have a problem paying for the healthcare of the poor

1 ( +5 / -4 )

A national health system really means that the wealthy will pay the bills for the poor.

Mr Kipling thinks this is an exceedingly good idea.

-3 ( +3 / -6 )

I bet he doesn't like that photo

0 ( +1 / -1 )

Why not Japan?

1 ( +3 / -2 )

Japan has racked up debts in excess of a quadrillion yen in no small part due to central governments health spending

Health insurance is expensive in Japan but I won't go bankrupt over a paper cut like in the US. The USA is also on a government debt suicide mission. Only difference is in Japan I'm safe from medical bankruptcy.

So, pretty well, while it lasts!

What year is it expected to collapse? Every year my medical premiums go higher and higher. When it collapses what exactly will happen? What are the specifics?

1 ( +3 / -2 )

InspectorGadgetToday 04:31 pm JST

You are correct. It was broken up about 20 years ago into the fragmented system that we have now. The idea was that regional health boards could provide better services targeted at their local communities. The problem was that they were never funded adequately, and you ended up duplicating systems and processes 20 times over with no economies of scale.

Moving back to a centralised system makes sense. The real concern is the addition of a Maori Heath Authority which, in effect, is treating people differently based on race.

Thanks can you also tell us which govt it was that introduced that system back then?

Was it a Labour Govt ?

0 ( +0 / -0 )

And it works pretty well in Japan. 

Japan has racked up debts in excess of a quadrillion yen in no small part due to central governments health spending, so hopefully the system doesn’t collapse whilst the population ages and runs out of people to pay taxes in support of it....

So, pretty well, while it lasts!

I have never heard of your Hollywood TV show, but in any case the Singaporean model achieves good outcomes with much lower spending as a % of GDP than both the UK and US systems, as noted above.

1 ( +2 / -1 )

> Bjorn TomentionToday  04:15 pm JST

How can anyone try to compare this to the UK system, there will be an Indigenous Maori Health Authority. No such special thing/group or allowance in the UK system is there.

From memory NZ used to have a national Health system until one of those previous govts decided to break it down and make localized health boards.

You are correct. It was broken up about 20 years ago into the fragmented system that we have now. The idea was that regional health boards could provide better services targeted at their local communities. The problem was that they were never funded adequately, and you ended up duplicating systems and processes 20 times over with no economies of scale.

Moving back to a centralised system makes sense. The real concern is the addition of a Maori Heath Authority which, in effect, is treating people differently based on race.

4 ( +5 / -1 )

profit = self-interest, is how we roll.

Adam Smith told us that it’s not out of benevolence that the butcher or the baker and the other guy provide us with goods and services, it is concern for their own self-interest.

Profit is not the same as self-interest.

But, if you're arguing that everything should be privatized, I'm glad to hear it. I will steal all your assets and pay off the cops not to arrest me with a portion of them.

-1 ( +4 / -5 )

I guess the central planners can make decisions better than individuals in control of their portion of the health budget.

yes, then that means less opioid deaths. And it works pretty well in Japan. What's the big problem.

Then, ask the recipients if they feel they have been getting value for money.

Are they living just as long or longer? Who on earth is happy about having major surgery in any country anyway? It just sounds like the comment of someone watching too many episodes of Dr. House MD. This is reality and not Hollywood

2 ( +4 / -2 )

“Singapore is achieving similar outcomes with less: spending about 4% of our GDP annually on healthcare, compared to 8% in the UK and 16% in the USA. Yet our health outcomes are comparable with many developed countries.”

https://www.moh.gov.sg/resources-statistics/educational-resources/achieving-more-with-less---singapore's-healthcare-expenditure

-1 ( +0 / -1 )

How can anyone try to compare this to the UK system, there will be an Indigenous Maori Health Authority. No such special thing/group or allowance in the UK system is there.

From memory NZ used to have a national Health system until one of those previous govts decided to break it down and make localized health boards.

3 ( +4 / -1 )

companies who are in it for the sole purpose of making a profit

profit = self-interest, is how we roll.

Adam Smith told us that it’s not out of benevolence that the butcher or the baker and the other guy provide us with goods and services, it is concern for their own self-interest.

1 ( +4 / -3 )

Wish the US would do this. That's the shaft central for healthcare. You get charged 100 dollars just for a single Band-Aide

5 ( +7 / -2 )

if you cant afford it then well, die.

That’s a pretty extreme summary, how about this instead.

Take the national health spending budget, and divide it up evenly per capita.

Then, ask the recipients if they feel they have been getting value for money. See what they think.

Then, instead of having central bureaucrats making decisions about how to spend the money, give control of the per capita amount to each individual instead - make sure that they can only spend it on health - but let each individual be in control of the money.

This is no radical approach. The exact same principles are in place for things like tax privileged retirement savings accounts. Individuals are in control of their share of the spending, not the middle-men bureaucrats and special interest groups that suck up to them at the tax payers expense.

0 ( +3 / -3 )

“We simply do not need 20 different sets of decision-makers."

Ah. Into the big government, central planning that always works wonders wherever it is tried.

He said the government had an ideology of centralized control.

Exactly my impression from the above statement too.

I predict worsening health outcomes for New Zealanders as a result.

Other places such as Singapore offer more attractive models, but no, I guess the central planners can make decisions better than individuals in control of their portion of the health budget.

0 ( +3 / -3 )

A national health care system is ethically a good idea but by definition it will be expensive and not offer top of the line treatment.

I don't understand that definition. Care to explain? As Cleo says above, big can afford economics of scale.

The evidence shows that the UK provides an excellent value for money system. The difficulty comes from its funding - there is pressure to keep taxes low and this can mean underfunding for certain areas. The UK has pretty poor statistics for cancer survival, for example.

3 ( +5 / -2 )

I don't fully understand the comparison with the UK. There are local boards/trusts in the UK too. (In Scotland alone, there are 14 health boards.) And the phrase "postcode lottery" is often used in sensational headlines about available treatment in the UK. Can someone explain the key differences?

5 ( +6 / -1 )

Great to see a government going in the right direction. Becoming fewer and far between these days.

Imagine that. Good leadership proactively making something better and more beneficial for the people they represent.

8 ( +11 / -3 )

anyway = any day

8 ( +9 / -1 )

by definition it will be expensive and not offer top of the line treatment.

the bigger the country, the bigger the problems with a centralized system.

No, no, and no.

Economy of scale, and cutting out the middle man, aka insurance companies who are in it for the sole purpose of making a profit, means a national health service beats a pay-through-the-nose system anyway.

15 ( +19 / -4 )

Alas, people tend to be dogmatic about this topic.

agreed certain political groups seem to think its not needed, because they dont want to pay a premium for healthcare, as healthcare unlike, my rights, should be pay for play, if you cant afford it then well, die. because capitalism should always put value on the rich and not the intelligence or content of a persons character. basic human rights only for those that can afford it

7 ( +11 / -4 )

New Zealand to consolidate healthcare into national service similar to Britain's

I have no problems with doing that, but politians should be honest about the tradeoff. A national health care system is ethically a good idea but by definition it will be expensive and not offer top of the line treatment. In a small countries like NZ, it can probably work well, the bigger the country, the bigger the problems with a centralized system. Alas, people tend to be dogmatic about this topic.

-12 ( +4 / -16 )

Once again, NZ is showing it is the best place to live.

Well, can't be the best place to live if they are just emulating the UK. As well, Canada has a social healthcare system but I don't believe there is a co-pay.

This came out this week: https://www.usnews.com/news/best-countries?src=usn_pr

1 ( +1 / -0 )

Great move. Maybe the UK will even take a leaf out of NZs book, and restore the NHS to its former greatness. Its currently being dismantled by stealth and sold off in bits.

8 ( +13 / -5 )

Once again, NZ is showing it is the best place to live.

11 ( +16 / -5 )

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