Health strike

A 48-hour strike by hospital lab workers and blood service workers has forced hospitals to cancel surgeries. This is a bigger deal than it sounds, due to the structure of the healthcare system in New Zealand.

Under the national health scheme in New Zealand (and similar programmes in other countries), care like surgery is free, but people go onto waiting lists. A person’s placement on the list is determined by a number of factors, including how critical their condition is, their age and general health, and other factors. The problem with having a surgery cancelled is that it has to be re-scheduled, and that can mean being reassessed and placed back on the list in a different part of the queue.

This is the drawback of nationalised healthcare systems: There’s never enough money to treat everyone immediately, so healthcare is inevitably rationed, with care going first to the sickest, those most likely to benefit, and those who are still in their most productive earning years.

However, in my view, that drawback is trumped by one simple fact: Everyone is entitled to healthcare and will get the procedures they need. There’s no need for private health insurance, and a health problem will never bankrupt anyone.

Contrast that with the totally private system in America, where tens of millions of people have no health insurance and millions more face bankruptcy if they develop a serious health condition. And consider, too, that America’s healthcare is increasingly rationed by HMOs and other group medical plans, so many Americans face rationed healthcare that they can’t afford.

Accidents in New Zealand are covered under a different scheme, and no one has to worry about getting emergency treatment if they’re injured. Care for injuries in car accidents is paid for, in part, by a levy on car insurance; care for workplace or general injuries comes from a levy on wages (similar to worker’s comp in the US).

The important consideration for Americans as they push for some sort of national health scheme, is which is more important: Universality or speed of access to medical procedures; the more you have of one, the less of the other. But America is a very rich country, and if any country could figure out a way to have both, they’re it.

In America, the main obstacle is the entrenched medical industry—for-profit hospitals, medical practices and drug companies. Without those barriers, New Zealand can make sure healthcare is universal which, to me, is the most important thing. American insurance companies are pushing for universality, but with a system they control.

It’s worth noting another difference: Huge numbers of prescription drugs are subsidised so the patient doesn’t pay the full cost. This is accomplished by having a central purchasing authority, which is something that the big pharmaceutical companies absolutely hate. In fact, it’s considered one of the main obstacles to a NZ-US free trade deal because for us it’s non-negotiable, but big US companies demand that it be scrapped.

Healthcare in New Zealand is available to all citizens and permanent residents (temporary residents—tourists and those here on limited work permits/visas—need private insurance). Dental care isn’t included at the moment, and that can be very expensive. Doctor visits are subsidised for growing numbers of people. Still, knowing that everything else is taken care of makes even these costs easier to deal with.

So, this strike will make things difficult for the patients affected. But at least the cost of their care won’t make them sicker.