Tuesday, August 25, 2009

What really is wrong with NZ's health system?

If you thought that what I wrote about the US health system was "strong", then take a quick browse through Tracey Barnett's effort in last Saturday's Herald. (probligo health warning; this op-ed might endanger the health of well-meaning Americans). One of the milder cuts -
I love America. It's the only country in the world where citizens pack an AR15 to go a'courting their President. When an economy is stressed, the truly wacked fringes always manage to find centrestage.

I went back to visit family last month, and there was Old Glory, limping along with the biggest single tax revenue drop since the Great Depression, like Paris Hilton with maxed-out credit cards and nothing to wear.

Alongside, and regrettably not on the net, was a small table setting out the current health spends for eight nations as a percentage of GDP. A fair measure as it closely relates to average personal income and is devoid of currency considerations. So, from memory, NZ ranked about 4th on that list with 9.6% just behind Australia and Waaayyyy behind the US at something like 16%. Now that is truly, when you consider the size of the US defence budget and the fact that two concurrent wars is costing little more than twice that proportion, truly frightening thing to consider.

The point was made though, that at the present rate of increase health spending in NZ will reach 22% of GDP by the year 2020 and that is even more frightening.

John Armstrong applied his well-muscled left arm to what the government is currently trying to do.
Was there political interference? Or did the high-powered taskforce charged with reviewing the public health system tailor the final version of its report in full awareness of the acute political sensitivity over the health portfolio?

Or did the group's members simply change their minds at the last minute and drop some of the more contentious things they had been planning to recommend?
That is because draft copies of the report leave little doubt that something or someone persuaded the review group, which was chaired by former Treasury boss Murray Horn, to water down or remove some of its more controversial suggestions before the final version was presented to the minister.

Even in its final form, the report has a fair degree of political risk attached to it.

The review group's reform recipe would gut the Ministry of Health and set up a National Health Board which would be responsible for allocating funding of health services with the intention of improving access to services and hospital productivity.

The recommendations bear a marked resemblance to National's hugely unpopular health reforms of the early 1990s which were designed to get more efficiency into the delivery of health services by forcing hospitals to compete with one another.

...and so on.

There is a fairly large matter here in the middle though which has far more to do with medicine and only a secondary look in at money.

I think, with some certainty, that the Bible refers to "man's allotted span" of "three-score years and ten". Now the ol' probligo isn't making any promises to pull the plug at his 71st birthday bash.

One does have to wonder at the western, Judeo-Christian, desire for eternal life in this world in preference to the next.

It is late, I am tired and cranky.

Is it any wonder that health budgets are inflated though, when faced with this kind of problem (once again from Saturday's Herald) -
The flood of alcohol-related hospital admissions during weekends is compromising the ability of hospital staff to tend to general admissions, doctors say.

The situation has prompted doctors to call for a rise in the age at which people can buy alcohol, The Press reported.

Wellington emergency department specialist Paul Quigley said large numbers of young people were coming in with alcohol-related injuries.

"This stuff is all preventable and it's very frustrating when you have people with heart pains or serious respiratory problems having to wait because staff are dealing with teenagers who have broken their wrist or been in a fight because they are drunk," he said.

One emergency department said patient numbers could double on Thursday, Friday and Saturday nights.

The bulk of admissions by people under 30 at weekends was directly related to alcohol, Dr Quigley said.

There was little remorse, and often those admitted appeared pleased with themselves.

Leave them in the gutter. What say you?

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