Monday, July 13, 2009

State (of) Health

I have been through this debate before, many times, and it has nothing to do with justifying the “nanny state” criticism of state welfare or public health services.

I live in a “collective” society, that is if you accept the epithetic nomenclature of the far right. NZ used to describe it as “cradle to grave” welfare and one (very brave Christian) Prime Minister called it “Applied Christianity”, but that came to a grinding and bankrupt halt in the 1970’s. We still have extensive welfare and health systems and I for one am fairly glad that we do.

I have health insurance, have had for some 25 years.

When I took out that insurance, one of the conditions that I had to sign on the application gave the insurer the right to access to my (existing) health records. Those records confirmed (because I had disclosed them on the application) that I had a (fairly serious) heart murmur and varicose veins. I was given a choice. Normal insurance at $1500 annually and the heart and varicose excluded from cover, or $2,100 and a $1,000 excess on all surgery. About 22 years later, the State provided me with free surgery and a good job well done to replace the mitral valve.

Now into my 60’s, I am very fortunate that for the moment my health insurance is provided by my employer. The annual cost is now $2500 annually. It will increase to close to $3,000 by the time I retire and at that point I will need to make some serious decisions.

But that is only part of the story.

Recent news in this country has a dispute of some considerable heat developing between all of the health insurance providers (there are 2 major and 4 minor) and most specifically the largest, and their customers.

The dispute has arisen over what the insurance provides, and what it does not. It is important to emphasise right from the beginning that there is no governmental intervention in the services provided by the insurers, or the cover that is provided.

Central to the argument is a new drug from the US (not herceptin this time) for the treatment of some cancers. It has been approved for use in this country but the government health bureaucracy has not yet purchased the drug for use in the state health system, primarily on the grounds of cost. This means that your doctor can prescribe it, you can get it readily from the pharmacist, provided that you pay the full price for it. There is no government subsidy.

So, buy the drug. Use it. Claim the cost from your insurer. Simple!


Turns out that the insurer has the contractual right to exclude (no reason required) any treatment not “approved”. Their general rule apparently starts with “not subsidised by the government”.

So, I have to ask, why am I paying for insurance?


This clip is pertinent, or so I am informed. If it is not, then I apologise. I have not looked because I spend enough time on the dial-up as it is without dragging in video. Broadband? Waddat?

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