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Overnight, American actor Jon Voight, the father of actress Angelina Jolie, condemned New Zealand's health care system (amongst others) at an anti-universal health care protest in Washington DC.
According to a report carried in today's Herald on Sunday, Voight, an Oscar winning actor stated, "We would be no better off than the European countries and Canada and New Zealand who suffer greatly from a poor healthcare system. Their rationing system creates many deaths."
As a former health sector bureaucrat, I did gain an insight into how the system works. Yes, our system is premised upon rationing. While I am uneasy about rationing, per se, it is an acceptable price to pay for not having a free market system.
Voight's remarks were just the latest to be uttered in the campaign against President Barack Obama's proposals to reform America's ramshackle, free market health system.. If anything, America has the developed world's most complicated and costly health system with only the very poor eligible for any form of federal government assistance. Otherwise, the vast bulk of Americans have to take out medical insurance for themselves and their families. In a majority of cases, employers provide health care coverage for their workers too, but if people move between jobs or lose them, this does affect their coverage.
President Obama is just the latest Democratic Party leader to take on this issue. Ever since 1948, all Democrat presidents (from Harry Truman on down) have tried and failed to institute health care reform. The powerful American medical insurance industry has held sway over successive generations of members of Congress. Their lobbying power has been unrivalled in terms of being able to fund the campaigns of most Congressional Republicans and a good number of right-wing Democrats. These two Congressional political factions have coalesced together in the past to defeat health care reform with the most recent instance being in 1994 when Bill Clinton's health plan was defeated.
Indeed, the private medical lobby have utilised the mass media with propaganda campaigns designed to scare ordinary Americans into thinking that any form of publicly financed health care is tantamount to socialism. Hence, any proposals for public funding of health care in America have met with stiff resistance from a population who have long been conditioned to think like this. Yet Americans also know the private cost of not having any form of state financed health care provision. Insurance premiums have skyrocketed to the point where over 45 million ordinary Americans (even those on middle class salaries) can't afford health care. There have been horror stories surrounding coverage being withdrawn from people who have long-term health conditions but yet don't earn a low enough income to qualify for the Federal Government's Medicaid programme. To qualify for Medicaid people must be in receipt of social security benefits. For older people, though, the story is different in that Medicare takes care of most of the health costs of those claiming a US Government pension. Even so, this programme doesn't extend (so far as I understand it) to people who receive their retirement income from private sources.
As you can see, there are huge gaps in health care coverage in America. President Obama's plan aims to plug some of them through mandating that all Americans purchase medical insurance at the risk of being fined. This sounds a very punitive and self-defeating measure if you ask me. Still, to ease the burden, all health care insurers will be asked to pool together in order to reduce premiums so as to make them affordable. Extra tax credits will also be made available to help individuals and families purchase health insurance.
As a last resort (and this is the nub of the issue for the American right) a publicly funded insurance pool will be set up to help drive competition and insure those who can least afford it. This move has been viewed as socialistic by universal health care opponents. Republicans and their private health insurance allies have been pushing this argument during the current campaign against health care reform.
Sadly, the scare campaign seems to be working with a growing number of ordinary Americans. Despite their private concern over how to meet their family health bills, they have latched on (yet again) to the false arguments being propagated by opponents like Jon Voight, as reflected in poll after poll. However, Congressional Democrats have continued to be brave enough to stay together and pass health care reform through the House of Representatives. One last obstacle remains, though, in the form of the Senate where there is a slender Democrat majority. For this reason, any hope of enacting health care reform might end there for Obama.
Despite the reservations I expressed at the beginning of this blog, the benefits of public health care clearly outweigh any disadvantages. To those who may be reading this (especially in the US) may I say that I can go and see my doctor (on the same day, if need be) for a low fee. If I needed to go to hospital or receive other specialist treatment, I don't have to think about how I'm going to pay for it. I've already covered that cost (as have other citizens) through taxes. While our New Zealand system may seem a bureaucratic jumble at times, at least (when compared with the US) there is an element of democratic control exerted through elected health boards and ultimately our Minister of Health is accountable for system performance through our Parliament. Our health system is one of the least costly in the OECD and our health statistics (across a wide range of measures) are comparatively better. For example, infant mortality rates in the US are the highest in the Western world while those recorded in New Zealand, Britain and Europe are amongst the lowest (and Voight has the cheek to talk about rationing creating many deaths). Yes, it is true that we ration, especially when it comes to surgery and other high level health interventions. Conversely, our politicians do set targets for our system to meet in respect of the numbers of people to be treated and the times they must wait. In the American free market system, there is no equivalent of this.
Above all else, that's why I favour (as do most New Zealanders) the maintenance of a largely public health system, financed through government taxes. I would like to close this blog by recollecting a conversation I had with an American exchange student recently. She was a student in one of my politics classes at the University of Otago. She needed to have her teeth done. Although she had medical insurance to meet her bills here, she found that the bill charged by our publicly funded dental school was far lower than any she would have received back home. She told me about the experiences of her family who, despite being middle class, were still swamped with huge health bills. Now, she wants to switch colleges and move to Oregon, a state that has a degree of universal health care coverage while she completes her undergraduate education. And she also revealed that she was thinking of coming to New Zealand to undertake postgraduate study.
There are many Americans like her who have come to appreciate the first class service given by our health system. Perhaps Jon Voight might like to visit and see for himself.
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Comments
Any system of compulsory
Any system of compulsory public funding of health services through taxation is by definition, socialist. And that is not acceptable to a large number of New Zealanders. Maybe a minority but still a large proportion of the population.
If the NZ public health system is so good why do a significant number of Kiwis also pay for private health insurance? The reason of course is that they want to have some choice about when their elective treatment might actually occur and to retain some individuality about the management of their case. So they pay twice to cover the odds.
Most private practitioners also work in the public system. You wait six months to see them for free but wave a few thousand dollars their way and you can see them tomorrow.
Even a potentially serious procedure such as mole removal is not covered by the public system. You actually have to have melanoma before the public system will cover the cost of removal which seems to me to somehow defeat the purpose of the exercise.
Dental treatment is not covered at all. The example given for the low cost of dental school treatment is because you are being treated by students. While I am sure the supervision is excellent you are still being treated as a guinea pig. If you choose to go to a regular dentist, which is what most people do the cost is alarming.
Where the NZ system does shine is accident and emergency treatment and major life threatening surgery, but anything cosmetic or only mildly disabling you are definitely on your own.
The US system suffers from extraordinarily bad administration in many ways, with complex billing practices enough to put anybody off but that does not justify the Obama plan to penalise people who don't have medical insurance by fining them. How does that help? And how can private insurers compete against the government in a marketplace? The private companies won't bother and the cost of treatment will sky rocket. Just look at the medicare fiasco.
I don't think Voight is wrong at all. All public health systems throughout the world are struggling to keep costs down. This Obama care plan is bad news for America. The US is already one of the most socialist countries on the planet when it comes to bureaucracy. Socialising medical treatment is not going to make it any better and will most likely make things a lot worse for the average people financially run as tax rates will rise.
The answer to looking after the low income and currently uninsured patients is to have them paying the medical practitioner directly whenever possible. Cut out all unnecessary government interference in the system. Clean up the administration in hospitals to use a single point of billing and let the marketplace do what it is perfectly capable of doing. Drive the cost of health care down through real competition.
We've seen the results of
We've seen the results of NZ's public system where government has poured hundreds of millions of dollars of taxpayers money (not their money) with very little productivity gain in return. waiting lists are longer than ever. NZ's system is hopelessly inefficient and resources are not allocated properly. The waste of hard earned tax payers money over the past 10 years is sickening. It's simply a failed model! Public / private partnerships are worth considering and compulsory medical insurance should be adopted. Singapore and Netherland systems are quite interesting and successful.
The US statistics around
The US statistics around infant mortality do not reflect their poor health system, but rather the large number of premature births that are experienced there, and the fact that all babies born breathing are counted in the statistics. Many other countries do not count premature babies who only survive briefly.
I suspect the difficulty of accessing abortion in many states also plays a role - mothers who are drug abusers, or who are too ill or poverty-stricken to carry their baby to full term in a healthy way cannot abort.
Having lived in the US and
Having lived in the US and NZ I know which I prefer! So what if you need to pay for (either directly or via private insurance) dental and elective surgery etc.
On my first visit to a A&E room in a very wealthy Californian city, I'd been waiting with a friend I’d driven there for about 2 hours when a guy came running in asking for help with a man in his car, spotted me (presumably the only person in the room not looking like I was suffering from anything) and got me to help him bring an elderly man in from his car. We barged through the waiting room doors and demand a doctor. The man had suffered from a stroke in the carpark (when this guy had spotted him).
Anyway what I learned was - he had a suspected stroke at home, the ambulance was going to take too long (and probably cost too much), so the wife had driven him in. At the time he had the second stroke in the carpark the wife had spend 20 plus minutes inside A&E trying to get help to fill in the Insurance forms. The elderly man lived but his prognosis was that he had suffered from severe brain damage.
One thing really wrong with the NZ system is the accountability, I can think of a couple of instances of severe malpractice causing death in NZ (impacting friends) where the doctors have walked away with less than a slap on the back of the hand (where in the US they would have lost their jobs and the hospitals or insurance would have paid out potentially millions). Anyway that’s a spinoff of ACC that could be resolved if there was more direct accountability, and not a socialism issue.
PS. My 2nd visit to a US hospital wasn’t much better.
I am a middle-class person
I am a middle-class person who has lived in both America and New Zealand, many years in both countries. I can state with absolute confidence that if you have no money at all, then New Zealand does "some things well" and you are better off here.
If on the contrary you are middle class, and you want newer detection technology and surgery and drugs and other trappings of a first world system, you are entirely out of luck. If you are poor and young and injured in a gory car crash, you are truly in luck. ACC will cover your expenses, and your care will be...."after a fashion". If you are middle-aged and get cancer, you are out of luck. If you want early detection and treatment of cancer in order to nip it in the bud, you are out of luck unless you go private. Hernias and gallstones are "elective" and the public system won't cover them. There is private insurance, for about half the cost in America per month, and half the quality of care as well. All the brilliant doctors leave the country. The public system will not cover any problem until it is considered "bad enough" to merit expenditure of public money. The problem is that by waiting until it is "very bad" to treat it, they may end up spending MORE money on it than if they simply had to funds to examine the problem earlier. And sometimes, it is so bad by then that you will simply be sent to hospice to die. And hope that the low-paid workers don't steal your pain meds.
New Zealand has many positive characteristics. The scenery is to die for. But if you don't die from that, the health care system will do you the favour.
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